Surge for narrow-spectrum antibiotics in times of the MDR crisis: Systematic literature review to establish the role of amoxicillin in tonsillopharyngitis


  • Summaiya Nizamuddin Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore Pakistan
  • Sana Anwar Liaquat National Hospital, Karachi Pakistan
  • Shamsa Kanwal University of Lahore, Lahore Pakistan
  • Usman Ashraf OrciTrials (Private) Limited, Lahore Pakistan
  • Kamran Khan OrciTrials (Private) Limited, Lahore Pakistan
  • Abdul Aleem Siddiqui OrciTrials (Private) Limited, Lahore Pakistan



Background: Group A Streptococcus (GAS) is the predominant pathogen accountable for tonsillitis, making it the most prevalent and frequently encountered bacterial cause of upper respiratory infections. Although amoxicillin is a frequently prescribed antibiotic for the treatment of tonsillopharyngitis, alternate agents like macrolides are regularly recommended. The objective of this study was to evaluate and compare the effectiveness of amoxicillin, its side effects, and the associated risk ratio with alternative antibiotic treatments for respiratory tract infections and tonsillopharyngitis in both children and adults.

Material and Methods: An initial search was performed via five basic databases PubMed, Medline, Embase, and the Cochrane Central Register of Controlled Trials, to identify studies meeting the inclusion criteria spanning from July 2012 to June 2023. The primary search of studies resulted in 6260 from four databases during the study period.

Results: After the initial scan of titles and abstracts, 06 studies were included in the review, which reported clinical cure rates. Four out of six studies reported adverse events.

Conclusion: Our analysis infers that given their narrow spectrum of activity, low incidence of side effects, comparable efficacy and cost-effectiveness, penicillin or amoxicillin can be considered as preferable choice for the management of tonsillopharyngitis and broad-spectrum antibiotics offer no added advantage in disease management.

Keywords: Amoxicillin, Tonsillopharyngitis, Tonsillitis, Acute respiratory infection, Streptococcal infection, GAS, SLR, Systematic literature Review, Antibiotics


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