title: [Pharyngeal A-streptococcal infection encountered in the practical work of an internal medicine specialist].
abstract: The problem of pharyngeal infections caused by beta-hemolytic streptococci of group A (BHSA) remains a challenge for both health providers and general medicine. The present paper was designed to provide the data suggesting the "reappearance" of a highly virulent BHSA infection and a rise in the frequency of its complications (such as acute rheumatic fever and toxic shock syndrome) and to substantiate the necessity of rational antibacterial therapy for the management of this pathology. The agents of choice for the treatment of acute forms of BHSA (tonsillitis and pharyngitis) include penicillins (amoxicillin, benzathine-penicillin, phenoxymethyl penicillin) and cephalosporins of the first generation (cephadroxyl) as well as macrolids (spiramycin, azithromycin, roxithromycin, midecamycin, josamycin) for the patients who do not tolerate beta-lactam antibiotics. Inhibitor-protected penicillins (amoxicillin, clavulanate) or cephalosporins of the second generations (cefuroxime-axetil) should be prescribed to the patients presenting with chronic recurring BHSA characterized by the rather high probability of colonization of the site of infection by beta-lactamase producing microorganisms. Lincosamine-derived antibiotics, such as lincomycin and clindamycin, are reserved for the patients with acute and chronic BHSA (tonsillitis and pharyngitis).
authors.forename: B S
authors.initials: BS
authors.lastname: Belov
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use; D006801:Humans; D007388:Internal Medicine / Q000379:methods*; D018942:Macrolides / Q000627:therapeutic use*; D010406:Penicillins / Q000627:therapeutic use; D010612:Pharyngitis / Q000188:drug therapy / Q000382:microbiology*; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000187:drug effects / Q000472:pathogenicity*; D014069:Tonsillitis / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D018942:Macrolides; D010406:Penicillins