Angina is excruciating for children and parents. The child has such severe pain that he refuses to eat, even when he is very hungry. He cries a lot, and every time the baby opens his mouth, you notice a red throat, which is troubling.
Why does this disease occur and what antibiotics are most effective for bacterial angina in children? We will tell you about this infection and which antibiotic is best for a child with angina.
What is angina?
Bacterial sore throat is a condition in which a baby's tonsils are affected by inflammation caused by bacteria. The amygdala is a lymphoid tissue located on either side of the pharynx, between the palatine arches. The palatine tonsils help the child's immune system to protect against various infections that enter the body through the mouth.
When the tonsils become infected, the tonsils become inflamed and enlarged.
Causes of bacterial sore throat
Bacterial infection is the second most common cause of angina after the virus.
Group A streptococci are the predominant cause of bacterial sore throat.
Some other bacteria can act as a causative agent of infection - these are chlamydia, streptococcus pneumoniae, staphylococcus aureus and mycoplasma. Rarely, angina can be caused by fusobacteria, pertussis, treponema pallidum and gonococci.
All of the above pathogens can seriously damage a child's health if the infection lasts a long time.
Symptoms
- Redness in the throat.Every time the child opens his mouth, you can see a distinct redness in the throat, where the tonsils are located. There may even be a yellowish or whitish coating on the top of the tonsils, which indicates purulent inflammation.
- Pain while swallowing.The child refuses to eat or drink anything, and even if he does, he stops halfway. The tonsils touch the root of the tongue and the palatine curtain when swallowing, and with angina, this action can cause excruciating pain.
- Cough. As the throat becomes irritated, the baby will cough constantly, thus increasing the pain.
- Excessive drooling.The child may not want to swallow due to an infection in the oropharynx. He accumulates drool in his mouth, and will drool more than usual.
- Ear pain.Pain from the tonsils can radiate to the ears, which makes the child poke at them, especially when he swallows and coughs. He will be capricious and cry whenever he pulls his ears.
- Fever.The child's body detects the presence of the pathogen and therefore increases the body temperature.
- Bad breath.Bacterial activity in the tonsils creates toxins and waste products of bacteria, as well as destruction of lymphoid tissue cells, which leads to bad breath in the baby.
- Swollen lymph nodes.The tonsils are part of the lymphatic system, and an infection can lead to swelling of the lymph nodes in the neck and under the jaw. Enlarged lymph nodes can be of different sizes.
- Rash.It occurs when group A streptococcus is the cause of the infection. The bacteria release the toxin into the baby's body, forming a red rash on the neck, back, abdomen and face. Small ulcers develop on the tongue, giving it a strawberry appearance. In severe cases, the tongue may turn dark red with white spots. This condition is called scarlet fever.
Angina can affect a child at any age. If you find any manifestations, contact a specialist to check the child.
Types of bacterial sore throat
- catarrhal sore throat.
The child complains of a sore throat, on examination, redness of the mucous membrane with a slight swelling of the tonsils is found. At first, the mucosal surface is dry and painful, the child often swallows saliva to moisten. In a short time, a secret is secreted, and the surface is covered with mucous pus. With severe inflammation, there is a slight swelling of the lymph nodes. Localized pain is characteristic;
- lacunar angina.
Lacunae (small depressions on the surface of the tonsils) are filled with a curdled substance that protrudes from them and consists of epithelial cells and various micrococci. This gives the amygdala a patchy appearance. The mucous membrane between the gaps is bright red and covered with pus, sometimes resembling a film. The oropharynx becomes painful and the pain spreads to the ear. The tongue is covered with a coating, bad breath occurs;
- follicular tonsillitis.
It is characterized by hyperemia (redness) of the mucous membrane of the oropharynx and the appearance of purulent follicles on the palatine tonsils, there is a whitish or yellow coating on the enlarged tonsils. Nausea is possible with occasional vomiting.
Complications
Without treatment for a long time, angina leads to the following conditions:
- acute rheumatic fever. This happens when antibodies that try to neutralize bacteria on the tonsils begin to attack the skin, joints, and heart. Symptoms of acute rheumatic fever develop two to four weeks after the onset of angina;
- sinusitis. This condition develops when the paranasal sinuses are blocked, leading to a violation of the outflow of pathological secretions from their sinuses. The bacteria then multiply, leading to disease. Sinusitis symptoms include severe nasal congestion, coughing, and nasal discharge;
- post-streptococcal glomerulonephritis. This is a kidney disease characterized by damage to the glomeruli, which are responsible for filtering fluids and toxins from the blood. This can lead to bloody urination, decreased urine output, pain or swelling in the joints;
- Toxic shock syndrome develops when group A streptococcus is in the body. It releases toxins and leads to toxic shock syndrome, a life-threatening disease. Symptoms include fever, low blood pressure, and rash;
- abscesses. These are limited accumulations of pus. With angina, abscesses can develop around the tonsils or in the back of the throat. In severe cases, they completely block the ability to swallow, speak, or breathe.
Diagnostics
The doctor makes a final diagnosis based on the following stages of the examination.
- Visual inspection of the oropharynx with angina. The baby's throat is carefully checked for signs of sore throat. Visible symptoms are the first indicator to identify an infection. Most medical professionals draw conclusions based on this examination.
- Detection of edema of lymphoid tissue. The tonsils swell when they become inflamed, which can also be accompanied by inflammation of the lymph nodes in the neck. The doctor will examine the skin around the neck and jaw for any swelling.
- Examination of the ears and nose. The pathogen can enter the body through these structures, causing a secondary infection in the tonsils. Additionally, a tonsil infection can continue to spread to different parts of the ear, nose, and throat.
- Laboratory examination of a throat swab. With the help of a sterile medical swab, a swab is taken from the tonsils, then it is sent to a laboratory to find out the exact type of bacteria that caused the sore throat. A throat swab helps to determine the exact cause and to identify the sensitivity of the pathogen to drugs.
- Blood test. A doctor may recommend a complete blood count. The presence of a large number of leukocytes in combination with other manifestations indicates the presence of angina.
As soon as the diagnosis is established - angina, the doctor recommends a medicine depending on the severity of the patient's condition.
Treatment
Treatment for bacterial sore throat should be started immediately. Therefore, when the first symptoms of the disease appear, the child should be shown to the doctor. You should not give your baby medication on your own, as incorrect therapy can lead to complications.
Typically, bacterial sore throat is treated with antibiotics.
Antibiotics are compounds used to treat bacterial infections. They are very useful medicines and save the lives of many children with serious illnesses such as meningitis, pneumonia and sepsis. Antibiotics can also be used to treat more common bacterial infections in children, including sore throat.
Infectious disease experts recommend testing to confirm the presence of the bacteria before antibiotics are prescribed. As a rule, if the diagnosis of bacterial sore throat is confirmed, a specialist will prescribe an antibiotic to the child.
Antibiotic therapy can be started immediately (without testing) when:
- the child's condition is moderate or severe;
- culture results will be ready in more than 72 hours;
- further monitoring of the patient will be difficult.
Antibiotics for angina in children will allow:
- eliminate bacteria and shorten the time of contagiousness (infectiousness). This reduces the likelihood of transmission of infection to others through close contact. The patient is usually not contagious 24 to 48 hours after starting antibiotic therapy;
- prevent possible complications such as sinusitis, otitis media, rheumatic fever and post-streptococcal glomerulonephritis;
- ensure faster disappearance of symptoms and faster recovery. Antibiotics shorten the duration of sore throat, discomfort, and fever.
Forms of antibiotics that are prescribed to a child with angina
- suspension.
The active part of the medicine is combined with the liquid to make it easier for the child to take the medicine or better absorb it. Before use, the suspension for children must be shaken well;
- pills.
The active ingredient is combined with another material and compressed into a round or oval solid. There are different types of pills. Soluble or dispersible tablets can be safely dissolved in water;
- capsules.
The active part of the drug is contained within a membrane that slowly dissolves in the stomach. Some capsules can be split so that the contents can be mixed with your favorite food. Others must be swallowed whole so that the medicine is not absorbed until the stomach acid dissolves the capsule shell.
What antibiotics to take for angina?
The choice of antibiotics depends on bacteriological and clinical efficacy, frequency of administration, duration of therapy, the presence of allergies in the patient, and potential side effects.
Penicillins
Penicillins are a group of antibiotics that block protein synthesis in bacterial cell membranes. Penicillins are a group of bactericidal agents including Penicillin G, Penicillin V, Ampicillin, Ticarcillin, Amoxicillin. They are used to treat infections of the skin, teeth, eyes, ears, and respiratory organs.
Children may be allergic to penicillin due to antibiotic hypersensitivity. Penicillins are often given in combination with various other types of antibiotics.
Penicillin B
Benefits
A good antibiotic for angina for children, which has proven its effectiveness and safety. According to a recent study, Penicillin is still considered the best choice for streptococcal sore throat treatment for non-penicillin allergy sufferers. For over 60 years, Penicillin has retained its ability to kill group A streptococci.
Penicillin has a narrow spectrum and therefore does not contribute to the development of antimicrobial resistance.
- Penicillin B is available in two forms. Tablets: 250 mg and Suspension: 125 mg or 250 mg in 5 ml; may contain sugar.
Penicillin B is usually given 5 times a day. This usually happens in the morning (before breakfast), around noon (before lunch), in the evening (before tea), and before bed.
Amoxicillin
Amoxicillin has a broader spectrum than penicillin. However, Amoxicillin has no microbiological advantage over the less expensive penicillin.
Benefits
More convenient treatment regimen. Some research suggests that amoxicillin given only once a day may work. Amoxicillin suspensions are better than penicillin suspensions.
Disadvantages
Gastrointestinal side effects and skin rashes are more common with Amoxicillin treatment.
Antibiotic release forms
Capsules: 250 mg and 500 mg. Suspension: 125 mg or 250 mg in 5 ml; some may contain small amounts of sugar.
Amoxicillin is usually prescribed three times a day: morning, afternoon and before bedtime.
Amoxicillin / Clavulanic Acid (Augmentin)
This drug can be seen as a more potent version of Amoxicillin, as the added component, clavulanic acid, can neutralize more bacteria.
The medication is used to treat the same types of infections as Amoxicillin, but is often used if the child's infection does not respond to the first choice of Amoccillin, or if the doctor thinks the child has a more serious infection.
Both Amoxicillin and Augmentin are members of the penicillin family of antibiotics and should not be taken if a child is allergic to penicillin.
The main adverse effect is diarrhea.
Release forms
- tablets: 250 mg amoxicillin / 125 mg, clavulanic acid, or in a ratio of components - 500/125 mg);
- dispersible tablets: 250/125 mg;
- suspension: 125/31 mg (125 mg amoxicillin, 31.25 mg clavulanic acid), 250/62 mg or 400/57 mg in 5 ml.
It is taken three times a day.
Macrolides
These antibiotics block the biosynthesis of bacterial proteins. They are usually prescribed for the treatment of children who are hypersensitive to penicillin. The action of the antibacterial drug in this group has a wider spectrum, in contrast to penicillin. Gastrointestinal discomfort (diarrhea, nausea) is a possible adverse reaction.
Azithromycin
Azithromycin, a macrolide antibiotic, is an effective treatment for streptococcal sore throat and is considered second-line therapy.
Benefits
- a smart choice for patients allergic to penicillins;
- can cure penicillin-resistant streptococcal infections;
- Azithromycin reaches high concentrations in tonsil tissue;
- very simple and short, single dosage, especially suitable for persons who do not wish to undergo a 10-day course of antibiotic therapy;
- relatively low risk of side effects from the gastrointestinal tract.
Disadvantages
- high bacterial resistance.
Release forms
- tablets: 250 mg, 500 mg;
- capsules: 250 mg;
- suspension: 200 mg in 5 ml; some may contain small amounts of sugar.
Azithromycin is usually given once a day; usually in the morning.
Clarithromycin
- very effective macrolide. One study shows that 10 days of Clarithromycin may be more effective in killing group A streptococci than 5 days of Azithromycin;
- among the disadvantages: increasing resistance of bacteria;
- Clarithromycin is usually given twice a day. Ideally, the interval between appointments is 10 - 12 hours, for example, between 7 and 8 am and between 7 and 8 pm;
- is available in the following forms:
- tablets: 250 mg or 500 mg;
- suspension: 125 mg or 250 mg in 5 ml;
- granules: 250 mg (per sachet).
Cephalosporins
This category of antibiotics combines bactericidal agents such as Cefadroxil, Cefapirin, Cefradin, Cefazolin, Cephalexin and Cephalothin. Cephalosporins, like penicillins, block the synthesis of proteins in bacterial cell membranes. They treat a wider range of bacterial diseases and can be used to treat diseases that cannot be cured with penicillins. If children are sensitive to penicillins, cephalosporins are given.
But usually, when a child is allergic to penicillin, he also develops an allergy to cephalosporins. Rashes, diarrhea, cramps, and stomach cramps are the adverse effects of these antibiotics.
Cephalexin
Benefits
- very effective;
- excellent option for recurrent infections.
Cephalexin has a relatively narrow spectrum and is therefore preferred over broad spectrum cephalosporins such as Cefaclor, Cefuroxime, Cefixime, and Cefpodoxime.
Disadvantages
- frequent reception.
Cefadroxil
Benefits
- effective;
- convenient one-time dosage;
- low incidence of gastrointestinal side effects;
- the suspension tastes good.
Cefuroxime and Cefdinir
Benefits
- very effective;
- safe for children and pregnant women (category B).
Disadvantages
- an unreasonably wide antibacterial spectrum.
Specialists do not recommend these medications because narrow-spectrum cephalosporins (Cefadroxil or Cephalexin) are preferred.
General guidelines for taking antibiotics
It is important for the child to complete the course of antibiotic treatment. This means that he must take the medicine for as many days as the doctor prescribed.
If you stop giving the antibiotic too early, the remaining bacteria will start growing again and may cause another illness. There is also a risk that these bacteria will be resistant (resistant) to the first antibiotic. This means it may not work the next time and the child may need another drug that may not work or cause more side effects.
Also, with antibiotic therapy, the following points must be considered:
- the dosage and type of antibiotic is selected only by a doctor, in accordance with the sensitivity of the pathogen, as well as the age and body weight of the child;
- children sometimes have vomiting or diarrhea while taking antibiotics. Encourage drinking of water to replenish fluid that the child loses from these side effects. If it is difficult or the child is lethargic, see a doctor;
- Do not give your child medicine to stop diarrhea unless the doctor has prescribed it.
- try to give the drug at about the same time every day. This will help you ensure that there is a constant concentration of the drug in the body in order to kill bacteria;
- Give the prescribed medicine to your child only for the current infection;
- only give the antibiotic to the child for whom treatment is prescribed. Never give the drug to anyone else, even when the condition is the same. It can be harmful;
- antibiotics are effective against bacteria; they do not fight viruses. This means they do not work against flu, viral sore throat, or other infections caused by viruses. The doctor does not prescribe antibiotics for these diseases;
- the course of therapy is 7 to 10 days. Children require strict bed rest, although after the start of antibiotic therapy on the 3rd - 4th day there is an improvement in the general condition;
- during the illness, one should refrain from walking and visiting crowded places.
Other remedies for the treatment of angina
- In addition to antibiotics, anti-inflammatory and antipyretic medications (Paracetamol and Ibuprofen) are used in the treatment of bacterial sore throat.
- If the throat is swollen, antihistamines are prescribed.
- It is also recommended to often rinse the mouth and throat to clear the tonsils from congestion and pus, moisturize the mucous membrane and relieve discomfort. For this purpose, you can use the following: solutions with salt, soda, furacillin; solutions with essential oils of fir, tea tree, cedar, eucalyptus; decoctions of sage and chamomile.
- The room in which the sick child is located should be well ventilated and subject to daily wet cleaning using disinfectants.
It is very easy to get infected with bacteria, so you need to protect your child's health and strengthen their immune system so that pathogens don't stand a chance. By understanding how to treat bacterial sore throat, following the doctor's recommendations, you can quickly get rid of this disease and prevent complications.
