Overcoming penicillin failures in the treatment of Group A streptococcal pharyngo-tonsillitis.
The causes of penicillin failure in eradicating Group A beta-hemolytic streptococcal pharyngo-tonsillitis (GABHS PT) are described. These include the presence of beta-lactamase producing bacteria that "protect" Group A beta-hemolytic streptococci (GABHS) from penicillins; the absence of bacteria that interfere with the growth of GABHS; co-aggregation between GABHS and Moraxella catarrhalis; and the poor penetration of penicillin into the tonsillar tissues and the tonsillo-pharyngeal cells. The use of antimicrobials that can overcome and modulate these phenomena and achieve better cure of the infection is described.
Brook
Itzhak
I
Department of Pediatrics, Georgetown University School of Medicine, Washington DC, USA. ib6@georgetown.edu
D006801:Humans; D001936:Moraxella catarrhalis / Q000187:drug effects; D045828:Moraxellaceae Infections / Q000150:complications / Q000188:drug therapy; D010406:Penicillins / Q000494:pharmacology* / Q000627:therapeutic use*; D010612:Pharyngitis / Q000188:drug therapy* / Q000382:microbiology*; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D014069:Tonsillitis / Q000188:drug therapy* / Q000382:microbiology*; D017211:Treatment Failure; D018440:beta-Lactam Resistance / Q000187:drug effects; D001618:beta-Lactamases / Q000378:metabolism
D010406:Penicillins; D001618:beta-Lactamases