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Etiology of acute pharyngitis in children: is antibiotic therapy needed?

Hsin Chi1, Nan-Chang Chiu, Wen-Chen Li

  • 1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, ROC.

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
|May 14, 2003
PubMed

Insights

This study on childhood acute pharyngitis found low rates of bacterial infections. Routine throat cultures and antibiotic use are not recommended for children with acute pharyngitis due to the low prevalence of significant bacterial pathogens.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Acute pharyngitis is a frequent pediatric upper respiratory infection.
  • Determining the causative microorganisms is crucial for appropriate treatment, particularly regarding antibiotic necessity.

Purpose of the Study:

  • To identify microorganisms associated with acute pharyngitis in children.
  • To evaluate the need for antibiotic prescription in pediatric acute pharyngitis cases.

Main Methods:

  • A study involving 416 children diagnosed with acute pharyngitis in an outpatient clinic.
  • Throat swabs were collected for viral and bacterial cultures.
  • Antibiotic prescriptions were managed based on initial suspicion and confirmed by culture results and clinical follow-up.

Main Results:

  • Out of 416 children, 297 potential pathogens were isolated from 242 patients.
  • Viruses were identified in 29.6% of cases, bacteria in 17.5%, and Group A Streptococcus in only 1.7%.
  • Mixed viral and bacterial infections occurred in 11.1% of patients; antibiotic prescriptions were significantly lower for viral or mixed infections upon follow-up.

Conclusions:

  • The low isolation rate of significant bacterial pathogens suggests routine throat cultures and antibiotic use are not indicated for children with acute pharyngitis.
  • Viral infections are more common in younger children, while older children with viral isolates may experience longer fever duration.

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