Modern approach to treatment of acute tonsillitis (angina) is as follows. Antibiotics should be used in well-defined cases where the objective methods (bacteriological examination of throat swab) confirmed that the causative agent of the disease is bacteria. In practice, antibiotics are used unnecessarily broad, often without a doctor's prescription, based on their own ideas about the proper treatment of the patient or on the advice of the employee pharmacy, including in cases of viral tonsillitis and pharyngitis. This leads to the fact that bacteria become resistant to antibiotics. Thus, in Russian resistance (stability) A beta-hemolytic streptococcus A to macrolide antibiotics (erythromycin, clarithromycin, azithromycin) observed in almost 10% cases, and in some regions — more often. Extremely high resistance to such marked antibaktrialnym drugs such as tetracyclines, sulfonamides (including co-trimoxazole), so these agents are not applicable for the treatment of angina. The only class of antimicrobial agents, which have beta-hemolytic streptococcus A does not develop resistance are the β-lactams (penicillins and cephalosporins), making them the drugs of choice for the treatment of streptococcal sore throat. The advantage of penicillin is also narrow the range of their activities and, accordingly, no negative impact on the normal intestinal microflora.
For patients allergic to penicillin can serve as an alternative to cephalosporin antibiotics I and II generation (cephalexin, cefuroxime, cefpodoxime) and amoxicillin. However, these antibiotics have a broader spectrum of action and may adversely affect the normal microflora. Application aminopenicillins (amoxicillin, ampicillin) in children requires caution. In childhood and adolescence, a high probability of disease infectious mononucleosis, which is caused by viruses. Against the background of this disease aminopenicillins use almost 100% of cases leads to a so-called "ampicillin" rash.
Sometimes the use of penicillin does not lead to success. This may be due to the fact that the pathogen is located intracellularly. In such cases it is possible the use of new drugs from the macrolides (josamycin).
The spectrum of antibacterial drugs for the treatment of angina (acute tonsillitis) is wide enough, but the problem is the commitment to treatment (compliance). Very often patients after 2-3 days on the back of significant improvement of health stop taking antibiotics. This is dangerous because it does not dolechenny acute tonsillitis may become chronic, and the bacteria which caused him acquire resistance to antibiotics, and deal with them in the future will be much more difficult.