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The use of cefaclor in the treatment of beta-haemolytic streptococcal throat infections in children.

Cefaclor was used as a therapeutic agent in beta-haemolytic streptococcal throat infections in children in 3 separate studies. Although the numbers of patients in these ongoing studies are too small for valid statistical analysis, cefaclor was found to be (1) an effective agent in a dose of 20 mg/kg/day, (2) as effective as phenoxymethyl penicillin at identical dosages, and (3) equally effective at doses administered twice daily or thrice daily. It was well accepted by the patients, had minimal side effects, and produced no adverse effects in the peripheral blood.

Adolescent↗

A rare suicidal case of a ten-year-old child stabbing himself in the throat.

A rare case is reported of a ten-year-old boy who committed suicide by stabbing himself in the throat with a pointed knife. Possibility of an accidental injury was excluded by the autopsy findings; suspicion of a homicide by his father was cleared through the deposition of his sister. The reason of suicide was attributed directly to his father's severe scolding and indirectly to his mother's death two years before.

Child↗

Recovery of group A and nongroup A beta-hemolytic streptococci from throat swab specimens.

The recovery of beta-hemolytic streptococci from throat swab specimens, from 1973 through 1975, was analyzed. Group A and nongroup A beta-hemolytic streptococci were recovered from 16.5% and 16.1%, respectively, of the specimens received. Although the recovery of group A streptococci fluctuated during the year, with the greatest incidence during the winter and spring months, the recovery of nongroup A streptococci was constant throughout the year. The proportion of group A to nongroup A streptococci was significantly greater in specimens collected during the winter and spring months than in those collected during the summer and fall months, and in specimens from pediatric patients than in those from adults.

Cost-Benefit Analysis↗

[Mouth and throat disinfectant preparation--dental aspects].

The oral fermentability of 10 mouth and throat disinfectant lozenges available in Switzerland were tested telemetrically. Because of their high sugar content all products produced immediate and long-lasting pH depressions in the interdental plaque except for a sugar-free preparation intended for diabetic patients. The cariogenic potential as well as the contraindication of such tablets in the treatment of infections of the oral mucosa, gingivitis, periodontitis or following dental surgery are shown.

Carbohydrates↗

Foreign bodies in the ear, nose and throat.

Foreign bodies in ear, nose and throat orifices should not be hastily removed. Inaction is the order of the day, with the exception of the larynx and trachea which have to be rapidly assessed, and the FB removed as a life saving procedure.

Ear↗

Bacterial interference in the throat flora during a streptococcal tonsillitis outbreak in an apartment house area.

During an outbreak of streptococcal tonsillitis in an apartment house area the interfering capacity of alpha-hemolytic streptococci isolated from the inhabitants' throat flora on the beta-hemolytic streptococcal strains recovered during the outbreak was investigated. Strains of alpha-streptococci with an inhibiting capacity on beta-streptococci were isolated mainly from individuals seemingly resistant to streptococcal tonsillitis while patients with repeated tonsillitis often had beta-streptococcal strains inhibiting the growth of the patients own alpha-streptococcal flora. Inhibiting alpha-streptococcal strains were isolated in high frequency in healthy patients that had recently recovered from tonsillitis.

Adolescent↗

Streptococcal disease control in an ambulatory practice. Explicit criteria for throat cultures.

A throat culture protocol was implemented in an ambulatory practice to standardize culturing and to conserve laboratory resources. A retrospective chart audit during three one-month study periods preceding (1976) and following protocol implementation (1978 and 1979) showed a significant effect on care-provider compliance with culture criteria (P<.0001). During a three-year period there was a significant decrease in the number of cultures done for patients younger than 2 years of age (23.6%, 6.9% and 0%; P<.001) and asymptomatic patients (19.4%, 13.9% and 3.1%; P<.001). From 1976 to 1978 there was a 50% decrease in cultures per 100 visits (12.3 versus 6.0). This change resulted in a three-year cost savings of $79,944. Of interest was the significant increase in the percentage of positive cultures between 1977 and 1978 (12.0% versus 18.8%; P<.001). This latter finding suggests that culture protocol criteria were selective for patients with pathogens.

Adolescent↗

[Testing of mucosa disinfection methods in the mouth and throat. 1. Effect of chlorhexidine gluconate and PVP-iodine on alpha-hemolytic streptococci].

A method for testing a throat antiseptic procedure is described. As indicator bacteria alpha-hemolytic streptococci were chosen. Povidone-Iodine and Chlorhexidindigluconate (0.5% and 0.1%) and aqua dest. as control substance were tested by a mouthwash technique. The best reduction of alpha-hemolytic streptococci could be detected after mouthwashing by 0.5% Chlorhexidindigluconate (1.4 log reduction), whereas by Povidone-Iodine a reduction of 0.85 log steps was achieved.

Chlorhexidine↗

International sore throats.

This paper reports on an international study of the diagnostic behaviour of doctors presented with patients complaining of a sore throat. Differences were found between individual doctors' predicted and actual behaviour, and between the behaviour of doctors in different countries.

Family Practice↗

Oral therapy with flurithromycin in ear, nose and throat infections.

In this study efficacy and tolerability of flurithromycin ethylsuccinate (FE) were evaluated in ear, nose and throat infections. One hundred and three patients were treated with FE tablets 375 mg 12-hourly for a mean duration of treatment of 8.2 days and they were divided into groups according to the pathology: pharyngitis/tonsillitis (chronic 7, acute 38), rhinosinusitis (chronic 7, acute 12), otitis (chronic 6, acute 32) and sialadenitis (acute 1). Patients evaluable for clinical efficacy were 101, among them a complete recovery was registered in 88.2%, an improvement in 9.9% and a treatment failure in 1.9%. Bacteriological evaluation was possible in 95 patients, showing the eradication of the pathogen in 94.7%. Tolerability was judged to be excellent in 81.6%, good in 15.5% and discrete in 2.9%. These results demonstrate that FE is safe and effective in the treatment of infections established on acute or chronic inflammatory states.

Adolescent↗

[Identification of Group A streptococci from throats of school children in Northern Taiwan].

A total of 2,750 strains of beta-hemolytic streptococci was isolated from 10, 510 throat swabs collected from school children in the Taipei area. Most of them were classified as group A (61%) and group G (34%), and about 5% belonged to other groups or unclassified strains. 1, 772 strains of beta-hemolytic streptococci isolated from healthy school children, and 69 strains from sick school children were grouped by the Lancefield precipitin test, fluorescent antibody technique and/or bacitracin paper disk method. A satisfactory correlation (over 90%) was obtained by the latter 2 methods, when compared with the results of the Lancefield technique. The occurrance of false negative or false positive was only 1 or 5%, respectively.

Bacteriological Techniques↗

An approach to ear, nose and throat assessment.

An approach is described for assessing ear, nose and throat problems, which may be of assistance to general practitioners in diagnosing common ENT problems. Making an ENT diagnosis requires your well honed skills of history taking and examination. This is aided by a few examination tools.

Humans↗

Epidemic streptococcal sore throat following a community picnic.

Following a picnic, nearly half of the persons who attended became ill. Sixty-three of 139 throat cultures were positive for group A beta-hemolytic streptococci. Forty-seven of the positive cultures were available for typing, 34 of which harbored the epidemic strain, group A beta-hemolytic Streptococcus type T-3/13/B3264. This contrasted with two of 204 controls who had not attended, but harbored the epidemic strain. Food preferences and illness rates implicated the potato salad, and from it the epidemic strain was isolated. The attack rate and case-to-infection ratio among those who attended the picnic was significantly greater for persons over 10 years of age. Prompt institution of chemoprophylaxis could possibly have prevented at least 50% of the cases.

Adolescent↗

Comparison of penicillin and trimethoprim-sulfamethoxazole in the treatment of ear, nose and throat infections.

A double-blind trial of penicillin and the combination trimethoprim-sulfamethoxazole was undertaken in adult patients with active infection of the ears, nose or throat. The results indicated that the drug trimethoprim-sulfamethoxazole was as effective as penicillin in achieving clinical improvement and showed a broader spectrum than penicillin the the elimination of pathogenic organisms. The difficulties in obtaining positive cultures that were reflective of the clinical condition are described.

Adolescent↗

[An explosive outbreak of strep throat morbidity in an adult organized collective].

Altogether 162 cases of tonsillitis were registered in two military units during the period of May 11-16. The disease took an acute course with short-time fever, symptoms of acute intoxication, sore throat, pronounced inflammatory changes in tonsils and swelling of regional (submaxillary and anterocervical) lymph nodes. In some of the patients (1.1%) sickness and vomiting and in 0.2% diarrhea were registered. In 6.7% of the patients scarlatiniform eruptions were observed on days 2-3 of the disease. In the course of the bacteriological examination of the patients group A streptococci, serovar T II, were isolated. The dynamic study of paired sera showed a considerable increase in the number of patients with a high level of antibodies to streptolysin 0 and group A polysaccharide. All patients were fed at the same canteen. The factor of the transmission of this infection could be butter, stored without observation of the required temperature conditions and apportioned by the soldiers of the kitchen police. Experimental study revealed that group A streptococci are capable for proliferation and accumulation in butter.

Acute Disease↗

Global monitoring of positive surgical outcome: a feasibility study at the Royal National Throat Nose and Ear Hospital.

We present early results of a study looking at the feasibility of positive outcome 'monitoring' after every operation at the Royal National Throat Nose and Ear Hospital. A system for quantitative 'measurement' of outcome after every operation is still light years away, and as a result audit of outcome has lagged behind audit of structure and process. Our 'monitoring' approach involves simply documenting, for every patient, whether the individual goal of the operation has or has not been achieved. Piloting this system over a 6-month period in 1993 suggests that it is feasible and useful, providing the results are used as pointers to more detailed study, rather than as endpoints in themselves.

Feasibility Studies↗

Uvulectomy to prevent throat infections.

It is common practice in many parts of Africa for traditional healers to remove the uvula to prevent infections and other disorders associated with the throat. We report two cases of children presenting with recurrent tonsillitis. On examination both children showed complete absence of the uvula and prominent tonsils. It was later revealed that they both had undergone uvulectomy, performed by traditional healers in Eritrea. We report this because this practice, although commonly performed, is little known to otolaryngologists practising outside Africa. In addition, although velopharyngeal competence seems to be maintained after uvulectomy, it may theoretically be at risk if adenoidectomy is performed in these patients.

Child↗

[Treatment of inflammatory diseases of the mouth and throat with Larypront in ENT practice (author's transl)].

Treatment of inflammations of the oral and pharyngeal cavities (glossitis, pharyngitis, pharyngolaryngitis, tonsillitis) in 60 patients with Larypront Throat Tablets alone, without administration of systemic antibiotics, gave very good results in 49 cases (81.6%) with complete regression of the complaints in 3-4 days. In 11 patients with acute pharyngitis and tonsillitis without demonstrable effect, systemic antibiotic therapy had to be added because of radiologically demonstrable acute sinusitis or increasing antibacterial infection. Side effects were not seen with the use of Larypront in any case.

Adolescent↗