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1、CLINICAL MICROBIOLOGY AND INFECTION VOLUME 18 SUPPLEMENT 1 APRIL 2012 ESCMID Guideline for the Management of Acute Sore Throat GUEST EDITOR Mical Paul Publication of this supplement was funded by ESCMID Guideline for the management of acute sore throat ESCMID Sore Throat Guideline Group C Pelucchi1
2、L Grigoryan2 3 C Galeone1 4 S Esposito5 P Huovinen6 7 P Little8and T Verheij2 1 Department of Epidemiology Istituto di Ricerche Farmacologiche Mario Negri Milan Italy 2 Julius Centre for Health Sciences and Primary Care University Medical Centre Utrecht Utrecht the Netherlands 3 Department of Family
3、 and Community Medicine Baylor College of Medicine Houston TX USA 4 Department of Occupational Health Giulio A Maccacaro Section of Medical Statistics University of Milan Milan Italy 5 Department of Maternal and Paediatric Sciences Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Universita
4、degli Studi di Milano Milan Italy 6 Department of Medical Microbiology and Immunology University of Turku 7 Division of Health Protection National Institute for Health and Welfare Turku Finland and 8 Primary Care and Population Sciences Group Faculty of Medicine University of Southampton Southampton
5、 UK Abstract The European Society for Clinical Microbiology and Infectious Diseases established the Sore Throat Guideline Group to write an updated guideline to diagnose and treat patients with acute sore throat In diagnosis Centor clinical scoring system or rapid antigen test can be helpful in targ
6、eting antibiotic use The Centor scoring system can help to identify those patients who have higher likelihood of group A streptococcal infection In patients with high likelihood of streptococcal infections e g 3 4 Centor criteria physicians can con sider the use of rapid antigen test RAT If RAT is p
7、erformed throat culture is not necessary after a negative RAT for the diagnosis of group A streptococci To treat sore throat either ibuprofen or paracetamol are recommended for relief of acute sore throat symp toms Zinc gluconate is not recommended to be used in sore throat There is inconsistent evi
8、dence of herbal treatments and acupunc ture as treatments for sore throat Antibiotics should not be used in patients with less severe presentation of sore throat e g 0 2 Centor criteria to relieve symptoms Modest benefi ts of antibiotics which have been observed in patients with 3 4 Centor criteria
9、have to be weighed against side effects the effect of antibiotics on microbiota increased antibacterial resistance medicalisation and costs The prevention of suppurative complications is not a specifi c indication for antibiotic therapy in sore throat If antibiotics are indi cated penicillin V twice
10、 or three times daily for 10 days is recommended At the present there is no evidence enough that indicates shorter treatment length Clin Microbiol Infect 2012 18 Suppl 1 1 27 Corresponding author P Huovinen Department of Medical Microbiology and Immunology Medical Faculty 20014 University of Turku T
11、urku Finland E mail pentti huovinen utu fi Background Acute sore throat is a symptom often caused by an infl am matory process in the pharynx tonsils or nasopharynx Most of these cases are of viral origin and occur as a part of the common cold Adults average two to four and children six to eight upp
12、er respiratory tract infections per year usually during the colder months of the year In addition to viral pathogens bacterial pathogens may also cause pharyngeal infections These pathogens include Streptococcus pyogenes group A b haemolytic streptococcus but groups C or G b haemolytic streptococci
13、as well as Mycoplasma pneumoniae and Chlamydia pneumoniae have also been suggested to be pathogens Although rare today in Europe streptococcal pharyngitis can be complicated by acute rheumatic fever or acute glomerulonephritis Fear of these complications or a wish to relieve pain or to satisfy patie
14、nts often lead physi cians to use antibiotic treatment for sore throat Acute sore throat is itself a symptom and pain or discomfort in the pharynx is not always caused by an 2012 The Authors Clinical Microbiology and Infection 2012 European Society of Clinical Microbiology and Infectious Diseases ES
15、CMID PUBLICATIONS10 1111 j 1469 0691 2012 03766 x infectious agent Conversely infectious agents are often found in the pharyngeal area in asymptomatic patients There is an apparent lack of studies on sore throat with simultaneous identifi cation of a wide spectrum of different infectious agents both
16、 bacterial and viral alone or mixed in symptomatic or asymptomatic children or adults and during different seasons The European Society for Clinical Microbiology and Infec tious Diseases ESCMID established the ESCMID Sore Throat Guideline Group to write an updated guideline to diagnose and treat patients with acute sore throat This guideline answers questions concerning the use of clinical diagnostic criteria and laboratory diagnostics to detect possi ble bacterial infection In addition to diagn
