Details about the treatment of angina with antibiotics

Zithromax Azithromycin for Angina treatment

Angina treatment with antibiotics is always done. If there is no specification in the diagnosis of "angina", this word means acute bacterial tonsillitis, which proceeds fairly quickly and without adequate antibiotic therapy, often leading to heart, brain, kidney, and other deadly complications.

The opinion that the treatment of angina with antibiotics may not be required, is found among non-specialists because of the use of angina as any inflammation of the throat, not only bacterial tonsillitis.

In particular, viral pharyngitis, which occurs with a variety of ARVI, chronic tonsillitis, inflammation of the throat in measles and diphtheria, is often confused with angina. These diseases do, in many cases, not require antibiotics for treatment, but they are not typical angina.

In medical practice, due to established habits, the term "angina" is also used for some diseases of a different origin. For example, herpetic angina caused by enteroviruses, or Simanovsky-Vincent's angina, not associated with streptococcus. These anginas are not typical, and when the doctor makes such a diagnosis, he necessarily specifies the type of the disease. If a specialist diagnosed an ordinary sore throat, it should be treated only with antibiotics.

On a note

A strict scientific medical name for angina is acute BHSA-tonsillitis. BGAA means that the main causative agent of the disease is -hemolytic streptococcus of group A, which is very dangerous in the absence of effective control. Significantly less often, angina is caused by staphylococci or a common streptococcal-staphylococcal infection, in extremely rare cases - gonococcus. In all these situations it is simply called an angina and is treated with antibiotics.

hemolytic streptococcus group A - the main causative agent of angina
Hemolytic streptococcus group A - the main causative agent of angina

The need for treatment of angina with antibiotics is the main rule in the fight against the disease. But antibiotic therapy itself must be carried out in accordance with several strict requirements.

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Three basic rules for the treatment of angina with antibiotics

Rule 1: Only the doctor should choose which antibiotics to treat angina in a particular patient in a particular case.

With this choice, many nuances are taken into account:

- The condition of the patient and the stage of the development of the disease;

- The patient has allergies to certain drugs;

- Possible stability of the causative agent of angina to any antibiotic (doctors usually have a certain idea of the infections that circulate in their area, and therefore, with a certain probability, they can predict which agents of the sore throat have resistance);

- Preference for different methods of administration of antibiotics - inside, intramuscularly, intravenously;

- Data of anamnesis in a particular patient, cases of angina and rheumatism in the past;

- Professional intuition and personal experience of a doctor ...

...and others. Antibiotic for the treatment of angina, selected by the patient on their own, can be most likely to be ineffective or dangerous specifically for this patient.

Rule 2: Treat the sore throat with antibiotics as long as the doctor has indicated.

In most cases, the main symptoms of the disease disappear within 2-3 days after the start of the effective remedy, and the patients themselves decide that the disease is cured and further antibiotic treatment is not required. In fact, at this time in the body there are still many streptococcus cells that can start to multiply when the drug is withdrawn. If at this time to stop the use of antibiotics, with a high probability of complications of the disease.

Rule 3: If the effect of taking antibiotics does not appear within 2-3 days, the drug should be replaced.

All effective antibiotics act against streptococcal infection very quickly. Most drugs completely destroy bacteria in the tonsils during the first 12-24 hours of admission, after a few hours, inflammation begins to decrease and the pain syndrome decreases. If this does not happen, then the antibiotic does not act on the infection and instead should be used effective.

Again, the remedy must be changed at the direction and under the supervision of the doctor. Fortunately, today medicine has at its disposal a sufficient number of funds that effectively destroy streptococcal infection.

Amoxicillin - another remedy, often used to treat angina

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What antibiotics are used for angina?

Treatment of sore throat is in most cases successfully carried out by simple and inexpensive antibiotics of the penicillin group.

They remain effective against streptococcus and can only misfire in some cases:

1. Angina is caused by staphylococcus, resistant to penicillins in particular or to β-lactam antibiotics in general;

2. Together with streptococcus in the tissues of the tonsils there are non-pathogenic bacteria that produce penicillinase, an enzyme that breaks down penicillins and makes them inactive against the causative agent of the disease.

The structural formula of flucloxacillin is the antibiotic of the penicillin group
The structural formula of flucloxacillin is the antibiotic of the penicillin group

Also, in some cases, it is not possible to treat angina with antibiotics of the penicillin family because of the allergy to them in the patient.

It is interesting

Allergy to antibiotics often develops due to the fact that previously the patient himself and not according to the rules took antibiotics, or interrupted their reception ahead of time. That is, in their allergy, most patients are to blame themselves, or if it is about children - their parents are to blame.

The main antibiotic of choice among penicillins is amoxicillin. It is very fully digested, rarely causes side effects, very quickly acts (faster than some other antibiotics even after intramuscular injection).

Preparations based on it - Augmentin, Amotite, Flemoxin Solutab and others. As part of the preparation Flemoxin Solutab this antibiotic is used to treat quinsy especially often due to its release in various pharmaceutical forms - tablets, capsules, granules for dissolution in water, powder for the preparation of injections.

Augmentin is used to treat many different infections caused by bacteria, such as sinusitis, pneumonia, ear infections, bronchitis, urinary tract infections, and infections of the skin.

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Other antibiotics of this group, effective for the treatment of angina are:

- Ampicillin;

- Phenoxymethylpenicillin;

- Benzathine is benzylpenicillin.

- Oxacillin;

- Azlocillin ...

…and others. Among them, new generation antibiotics (oxacillin, fluclosacillin) are resistant to penicillinase and can be used in situations where the causative agent is resistant to amoxicillin or ampicillin. They are very expensive.

On a note

To date, penicillins - the most innocuous antibiotics for the treatment of angina. They are least likely to affect the bacterial background of the gastrointestinal tract, with proper application rarely cause allergic reactions. It is their doctors prescribe during pregnancy and lactation.

3D model of the penicillin molecule
3D model of the penicillin molecule

Also for the treatment of angina are suitable preparations of antibiotics of the penicillin series:

1. Bicillins - Bicillin-1, Bicillin-3, Bicillin-5, Moldamine, Retarpen, Extenсillin. They are based on the salts of benilpenicillin, the main feature of which is a very slow release into the bloodstream and a prolonged effect on the infection. These antibiotics are used either to treat angina in patients who do not follow the doctor's instructions and do not drink tablets (bicillins are administered only intramuscularly) or to prevent complications of angina after the end of the course of taking another drug.

2. Inhibitor-protected penicillins. They are either a mixture of amoxicillin with clavulanic acid (Augmentin, Amoxiclav, Flemoclav Solutab), or a mixture of ampicillin and sulbactam (Sultamycillin, Ammiсide). In them, clavulanic acid or sulbactam neutralizes the protection of bacteria, and the antibiotic itself leads to their death.

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If, in a particular case, penicillins do not have an effect, or can not be used because of an allergy to them in the patient, the doctor decides to treat the angina with another antibiotic:

1. Cefadroxil - comparable in safety and efficacy with amoxicillin;

2. Other antibiotics of the cephalosporin group: cephalexin, cefaclor, ceftriaxone;

3. Antibiotics of the macrolide family - erythromycin, azithromycin, josamycin and others.

Erythromycin, by the way, is one of the most famous antibiotics for the treatment of angina. Today, due to its too active use in about 5-10% of cases for different countries, it turns out to be ineffective due to the developing resistance of streptococcus to streptococcus. However, popularity, affordability and low price make it one of the most commonly prescribed means of non-penicillins. Its main drawback is a large number of side effects from the digestive tract.

Today, of all macrolides for the treatment of angina, the most desirable antibiotic of choice is azithromycin. This substance has a unique ability to be transported to the site of inflammation with the cells of the immune system, it is also quite safe, and is therefore often used to combat angina in children. The most common azithromycin preparations are Azivok, Azitro-Sandoz, Sumamed.

Only in the case when neither macrolides nor β-lactam antibiotics can be taken in the treatment of angina, the patient can be prescribed lincosamides. These agents often cause side effects and have less satisfactory pharmacokinetic properties.

Very severe antibiotics such as levomycetins and aminoglycosides with angina are not prescribed. The consequences of their admission may be more severe than angina itself.

The form of the course of the disease has practically no effect on the doctor's decision about which antibiotics to treat the sore throat. Lacunar angina is treated with the same drugs as the catarrhal or follicular: the causative agent of these diseases is the same, and the medicinal substances equally easily penetrate into all places of localization of bacteria. Various symptoms of angina - pain, temperature, intoxication - practically do not influence the choice of medication, but determine the choice of auxiliary therapeutic agents.

It is important to understand that the price of the drug is often not correlated with its effectiveness. Cheap erythromycin will be just as effective against sore throats as expensive ticarcillin. Expensive antibiotics usually treat sore throat in situations when the patient has developed an allergy to cheap ones. It is completely unreasonable to "beg" the doctor of an expensive imported antibiotic just because it seems more solid and powerful. Today, angina is quite successfully treated with such antibiotics, which are cheaper than symptomatic treatment - antipyretic and analgesic.

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On a note

In the ideal case, before the appointment of antibiotics, the doctor must determine the pathogen and its resistance to different substances. In practice, this definition requires a fairly long study, which lasts 3-4 days - bacterial culture or PCR. Rapid same antigenic tests are very expensive (their cost exceeds usually the cost of treating sore throats). Therefore, almost always the doctor intuitively prescribes for the treatment of angina a broad-spectrum antibiotic, and if he does not give a result - replaces it with a means of another class. This tactic saves time and almost always gives a result.

Also, both children and adults use the same antibiotics. Virtually all drugs effective against streptococci are allowed to be taken from birth, while angina in principle can not develop earlier than half a year of life because of the lack of tonsil in the child. Therefore, it is absolutely normal if the doctor prescribes the same remedy to both the child and the adult. Children are only sometimes prescribed drugs in other dosage forms - for example, the same Flemoxin Solutab or Azitro-Sandoz in the form of suspensions.

When pregnancy and breastfeeding under the supervision of a doctor angina can be treated with penicillins - all the same amoxicillin, ampicillin (it is preferable in these cases because of less active pharmacokinetics) - as well as cephalosporins. When using these antibiotics, breastfeeding can not be stopped, but the pediatrician must monitor the child's condition.

Ampicillin is a semisynthetic penicillin antibiotic

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Tablets or injections?

Most often antibiotics for the treatment of angina are taken internally. For adults, tablets or capsules are prescribed, for children - powder for the preparation of suspensions. Most drugs are available in different forms, which gives the doctor greater freedom of choice. In a civilized world, antibiotics are injected only in such situations:

1. The patient can not or categorically refuses to drink tablets. This happens in the treatment of patients in psychiatric clinics, prisoners, patients who are in an unconscious state;

2. The patient does not have the opportunity to take an antibiotic regularly. In this case, an injection of bicillin is made, which will last a very long time - up to several weeks;

3. It is necessary to prevent complications of angina for a long time. Such prophylaxis is carried out only by bicillins, and they, in turn, are administered only intramuscularly;

4. Severe dyspeptic disorders, vomiting in the patient;

5. A limited set of drugs, when at hand there are only antibiotics for intramuscular injection.

In other cases, almost always the injections can be replaced by ingestion of an antibiotic. This is especially true for children, since injections of antibiotics are painful and can cause persistent fear of treatment. At the same time, theoretically injections are more effective and reliable.

In any case, if the usual patient (and especially the baby) the doctor prescribes injections of antibiotics, be sure to ask why it is impossible to replace injections with tablets or suspensions.

Antibiotics for angina are taken only systemically. They are administered into the body in three ways:

1. Orally - in the form of tablets, capsules or suspensions;

2. Intramuscular (usually in the buttock);

3. Intravenous - in the clinic.

Other ways of treating angina with antibiotics - rinsing their throats, dissolving candies, inhalation, lotion - are ineffective and do not allow to fight the pathogen. If such methods try to replace a full-fledged systemic intake of drugs, with a high probability of angina complicates.

Heart failure is one of the complications of angina with wrong treatment
Heart failure is one of the complications of angina with wrong treatment

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Treatment of angina with antibiotics: regimen and rules for receiving funds

As a rule, treatment of mild to moderate angina is carried out at home. Antibiotics doctor prescribes either in the clinic, or at the exit to the house to the patient.

Only in severe situations with a significant violation of the physiological state of angina is required to be treated in a clinic. In the photo - treatment of sore throat with antibiotics with intravenous jet administration of drugs:

Treatment of sore throat with antibiotics with intravenous jet administration of drugs
Treatment of sore throat with antibiotics with intravenous jet administration of drugs

For the period of acute course of the disease for the patient, bed rest is organized, it must be isolated from others. The antibiotic itself is taken in accordance with the instructions for use - for each drug there may be different nuances: depending on the dosage, a different frequency of reception of the drug may be prescribed, different amounts of the drug are prescribed for children and adults.

This should first say the doctor (and the patient or his parents should understand this well), and then again it is necessary to compare the treatment with the instruction to the specific drug.

In any case, the capsules and suspension are usually taken either one hour before a meal or two hours after a meal. Tablets can be drunk regardless of meals.

The main requirement in the treatment of angina antibiotics at home: abundant drink and food only if desired. Drink as much as possible - in this case, the temperature will drop and the bacterial toxins and decay products from the body will be eliminated faster. It is impossible to force the patient to have a sick person (including a child) - excess food with a reduced tone of the body can lead to eating disorders.

The food itself for the patient with angina should be soft, preferably in the form of puree, not spicy and not salty.

Apple puree - one of the recommended dishes with angina
Apple puree - one of the recommended dishes with angina

The severity of bed rest when treating angina with antibiotics is relative. If the patient feels well enough to take a walk in the fresh air, he can safely walk. If a child wants to run around the apartment while playing angina and play - he can be boldly allowed to do it.

At the end of the acute period of the disease (with a drop in temperature and normalization of well-being), the patient can and should even walk. As a rule, 2-3 days after the beginning of taking the antibiotic, the patient feels well enough to lead a normal life.

How long is the sore throat and how long should bed rest?

From an official point of view, a patient with angina ceases to present an epidemiological danger to others 7-10 days after the start of taking an effective antibiotic. In fact, after elimination of the pathogen from the tonsil tissue, the sore throat is no longer contagious. That is, from the moment when the patient ceases to have a sore throat and temperature decreases, it is safe to communicate with him. Usually this happens on the 2-3 day of treatment. To insure sick children are not allowed into schools and kindergartens until the end of the course of antibiotic treatment and getting an appropriate certificate from a doctor.

Increased body temperature and sore throat is an indirect sign that the patient is infectious
Increased body temperature and sore throat is an indirect sign that the patient is infectious

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Terms of antibiotic therapy

In the usual case, the antibiotic in the treatment of angina is prescribed for a period of 10-12 days. In very difficult situations, when signs of the presence of an agent in the body remain at the end of this period, treatment can be extended to a total duration of 21 days.

You can not treat the sore throat with antibiotics for less than 7 consecutive days. Medical practice shows that when taking antibiotics for a shorter period, the number of serious complications of the disease increases dramatically up to sepsis and heart lesions.

For this reason, by the way, it is forbidden to stop taking antibiotics immediately after normalization of the patient's condition. Treatment should last as long as the doctor has indicated, and if any side effects appear for the remaining period, the drug is replaced with another antibiotic.

Antibiotics need to start drinking no later than 9 days after the onset of the disease. It is interesting that at the beginning of treatment for 3-4 days of angina, the probability of complications is lower than when antibiotics are started in the first two days of the disease.

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Safety of antibiotics

All antibiotics, even the most harmless, can cause side effects. Depending on the type of drug and its interaction with the patient's body, the probability and severity of these or those disorders varies widely - some drugs cause side effects extremely rarely, for others this is normal. The consequences of taking some medications can be almost invisible, while in other drugs side effects are more severe than angina itself.

The most common side effects of taking antibiotics with angina are:

1. Digestive disorders, including those in infants whose mothers are taking antibiotics;

2. Dizziness, headache;

3. Allergies - from rashes on the skin to anaphylactic shock (in extremely rare cases).

All these side effects with antibiotics are much less likely to occur than complications of angina with antibiotic withdrawal. Therefore, it is necessary to treat the sore throat with antibiotics - it is a more competent and safe approach to one's own health.

As a rule, most side effects can be avoided with the proper appointment of an antibiotic, when the doctor correctly evaluates the characteristics of a particular patient and the properties of the drug itself.

If side effects appear, the doctor decides to replace the medication or prescribe medications to correct these disorders. The task of the patient here is to closely interact with the doctor as closely as possible and to follow all his instructions.

Any antibiotic is contraindicated if the patient has an allergy to it. Additional contraindications for each particular drug may be pregnancy or lactation period (in some cases, breastfeeding for the treatment of angina should be discontinued), bronchial asthma, kidney disease. Therefore, in each case, to determine which antibiotic can treat angina, only a specialist can.

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Auxiliary therapy: how to relieve symptoms of sore throat?

Almost always to treat sore throat at home with antibiotics is necessary with the use of ancillary drugs. An exception is unless catarrhal angina in adults, often proceeding quite easily and not requiring symptomatic therapy.

Absence of visible abscesses on tonsils - a distinctive feature of catarrhal sinus
Absence of visible abscesses on tonsils - a distinctive feature of catarrhal sinus

Depending on the symptoms, the treatment of angina with antibiotics may require the use of:

1. Antipyretics - Paracetamol, Nurofen and their analogues. They should be used if the temperature has risen above 39 ° and because of this the patient feels frankly bad;

2. Antihistamines for the removal of inflammation;

3. Systemic painkillers - Aspirin, the same Paracetamol or Nurofen, Tempalgin - if the pain in the throat is too strong and interfere with drinking and eating;

4. Local anesthetics - sprays and lozenges with analgesics (do not confuse them with candies with antibiotics), which can reduce pain syndrome;

5. Preparations for rinsing throat - decoction of herbs, solutions of antiseptics, agents with analgesics. They allow you to ease the pain and wash away part of the pus from the tonsils;

6. Anti-inflammatory drugs - in cases where the tonsils increase to such a size that they interfere with normal swallowing.

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In the photo - inflammation of the tonsils to such an extent that they interfere with the ingestion of food:

inflammation of the tonsils to such an extent that they interfere with the ingestion of food

Means of symptomatic treatment are not mandatory and apply only when necessary. Use only them instead of antibiotics can not - they do not affect the cause of angina, will not allow to eliminate the pathogen and prevent the development of complications.

It is important to understand that it is impossible to treat angina without antibiotics. Any other remedy can only affect the symptoms of the disease, but its causes do not eliminate it.

You can not treat angina with antibiotics in the form of lozenges or solutions for rinsing your throat. With topical application of antibiotics, bacteria develop resistance to these agents much faster, and body allergy takes place with the same frequency as with systemic administration of funds.

At the same time, antibiotics in candies and in solutions for rinsing the throat have virtually no effect on the causative agent of angina.

On a note

Solutions antiseptics are also of little use in the treatment of angina. They can decontaminate only the surface of the tonsils, while the focus of infection is in the deep tissues. Effects on infection do not have antiseptics.

A solution of furacilin is a known antimicrobial throat rinse
A solution of furacilin is a known antimicrobial throat rinse


1. Angina should be treated with antibiotics;

2. Angina is quite successfully treated with simple, sufficiently harmless and inexpensive antibiotics;

3. Only a doctor should choose a specific drug for a particular patient with a specific angina. He can replace the remedy in case his application does not give a result;

4. It is possible to treat tonsillitis with antibiotics and in many cases it is necessary at home, but the doctor should prescribe the treatment, it is not important - at home or in the hospital;

5. Any remedy, other than antibiotics, is intended only for the symptomatic treatment of angina. Only they can cure the disease and prevent the development of complications is impossible.

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