Surge for narrow-spectrum antibiotics in times of the MDR crisis: Systematic literature review to establish the role of amoxicillin in tonsillopharyngitis
DOI:
https://doi.org/10.61529/idjp.v33i1.268Abstract
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, clinicaltrial.gov 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
References
Vazquez MN, Sanders JE. Diagnosis and management of group A streptococcal pharyngitis and associated complications. Pediatr Emerg Med Pract. 2017; 14(12): 1-20.
Randel A. Infectious Disease Society of America. IDSA Updates Guideline for Managing Group A Streptococcal Pharyngitis. Am Fam Physician. 2013; 88(5): 338-40.
Silva-Costa C, Friães A, Ramirez M, Melo-Cristino J. Macrolide-resistant Streptococcus pyogenes: prevalence and treatment strategies. Expert Rev Anti Infect Ther. 2015; 13(5): 615-28. DOI: https://doi.org/10.1586/14787210.2015.1023292
Hersh AL, Fleming-Dutra KE, Shapiro DJ, Hyun DY, Hicks LA. Frequency of first-line antibiotic selection among US ambulatory care visits for otitis media, sinusitis, and pharyngitis. JAMA Intern Med. 2016; 176(12): 1870-2.
Melander RJ, Zurawski DV, Melander C. Narrow-spectrum antibacterial agents. Medchemcomm. 2018; 9(1):12-21.
DOI: https://doi.org/10.1039/C7MD00528H
Mustafa Z, Ghaffari M. Diagnostic methods, clinical guidelines, and antibiotic treatment for group A Streptococcal Pharyngitis: A narrative review. Front Cell Infect Microbiol. 2020; 10: 563627. DOI: https://doi.org/10.3389/fcimb.2020.563627
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 372: n71. DOI: https://doi.org/10.1136/bmj.n71
Higgins, JPT, Green, S. (Eds.). (2011). Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0) [Updated March 2011]. The Cochrane Collaboration. www.training.cochrane.org/handbook
Leelarasamee A, Leowattana W, Tobunluepop P, Chub-upakarn S, Artavetakun W, Jarupoonphol V, et al. Amoxicillin for fever and sore throat due to non-exudative pharyngotonsillitis: beneficial or harmful? Int J Infect Dis. 2000; 4(2): 70-4. DOI: https://doi.org/10.1016/s1201-9712(00)90097-3
Kuroki H, Ishiwada N, Inoue N, Ishikawa N, Suzuki H, Himi K, et al. Comparison of clinical efficacy between 3-day combined clavulanate/amoxicillin preparation treatment and 10-day amoxicillin treatment in children with pharyngolaryngitis or tonsillitis. J Infect Chemother. 2013; 19(1): 12-9. DOI: https://doi.org/10.1007/s10156-012-0444-1
Eslami ST, Nassirian A, Nassirian H, Hatami E, Sobhani E, Najibpour. Comparing performance of amoxicillin and intramuscular benzathine penicillin in relieving manifestations of streptococcal pharyngitis in children. Ghana Med J. 2014; 48(4): 185-8. DOI: https://doi.org/10.4314/gmj.v48i4.3
Gerber JS, Ross RK, Bryan M, Localio AR, Szymczak J. E, Wasserman R, et al. Association of broad- vs. narrow-spectrum antibiotics with treatment failure, adverse events, and quality of life in children with acute respiratory tract infections. JAMA. 2017; 318(23): 2325-36. DOI: doi.org/10.1001/jama.2017.18715
Li P, Jiang G, Shen X. Evaluation of 3-day azithromycin or 5-day cefaclor in comparison with 10-day amoxicillin for treatment of tonsillitis in children. Canadian J Physiol Pharmacol. 2019; 97 (10): 939-44. DOI: https://doi.org/10.1139/cjpp-2019-0087
Bar-Yishay M, Yehoshua I, Bilitzky A, Press Y. Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community. European J General Pract. 2022; 28(1): 142–9. DOI: https://doi.org/10.1080/13814788.2022.2083105
Spinks A, Glasziou PP, Del Mar CB. Antibiotics for treatment of sore throat in children and adults. Cochrane Database Syst Rev. 2021; 12(12): CD000023. DOI: https://doi/org/10.1002/14651858.CD000023
van Driel ML, De Sutter AI, Thorning S, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst Rev. 2021; 3(3): CD004406. DOI: https://doi.org/10.1002/14651858.CD004406.pub5
Altamimi S, Khalil A, Khalaiwi KA, Milner RA, Pusic MV, Al Othman MA. Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children. Cochrane Database Syst Rev. 2012; (8): CD004872. DOI: https://doi.org/10.1002/14651858.CD004872.pub3
Munck H, Jørgensen AW, Klug TE. Antibiotics for recurrent acute pharyngo-tonsillitis: Systematic review. Eur J Clin Microbiol Infect Dis. 2018; 37(7): 1221-30. DOI: https://doi.org/10.1007/s10096-018-3245-3
Zafar A, Hasan R, Nizamuddin S, Mahmood N, Mukhtar S, Ali F, et al. Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: A review of results from the Survey of Antibiotic Resistance (SOAR) 2002-15. J Antimicrob Chemother. 2016; 71 Suppl 1(Suppl 1): i103-9. DOI: https://doi.org/10.1093/jac/dkw076
Koga T, Rikimaru T, Tokunaga N, Higashi T, Matsuo K, Nakamura M, et al. Evaluation of short-term clinical efficacy of 3-day therapy with azithromycin in comparison with 5-day cefcapene-pivoxyl for acute streptococcal tonsillopharyngitis in primary care. J Infect Chemother. 2011; 17(4): 499–503. DOI: https://doi.org/10.1007/s10156-010-0207-9
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