Related Experiment Videos
Penicillin tolerance in group A streptococci and treatment failure in streptococcal tonsillitis
A Stjernquist-Desatnik1, A Orrling, C Schalén
1Department of Otorhinolaryngology, University of Lund, Sweden.
Abstract:
Penicillin tolerance in Streptococcus pyogenes has been suggested as a possible cause of therapeutic failure in streptococcal phryngitis treated with penicillin. In 144 patients with acute group A streptococcal tonsillitis treated with phenoxymethyl penicillin 12.5 mg per kg body weight b.i.d. for 10 days the same T-type was recovered after treatment in 21%. The recovery rate was higher for non-tolerant strains, 23%, than for tolerant strains, 10% (p greater than 0.05). Of patients with a non-tolerant strain 17% had both clinical and bacterial treatment failure in comparison with 5% infected with a tolerant strain (p greater than 0.05). Reinfection with a new serotype occurred in altogether 3%. The present data did not indicate that penicillin tolerance in group A streptococci is of significance in acute tonsillitis treated with phenoxymethylpenicillin for 10 days.
Insights
Penicillin tolerance in Streptococcus pyogenes did not significantly impact treatment outcomes for acute tonsillitis. This study found no strong evidence linking tolerant strains to therapeutic failure in patients receiving phenoxymethylpenicillin.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Penicillin tolerance in Streptococcus pyogenes is a potential factor in treatment failures for streptococcal pharyngitis.
- Understanding the role of bacterial tolerance is crucial for optimizing antibiotic therapy.
Purpose of the Study:
- To investigate the significance of penicillin tolerance in Group A Streptococcus (GAS) during acute tonsillitis treatment.
- To determine if penicillin-tolerant GAS strains are associated with treatment failure.
Main Methods:
- A study involving 144 patients with acute group A streptococcal tonsillitis.
- Patients were treated with phenoxymethyl penicillin (12.5 mg/kg body weight twice daily for 10 days).
- Bacterial strains were analyzed for penicillin tolerance post-treatment, and clinical outcomes were assessed.
Main Results:
- The same GAS type was recovered post-treatment in 21% of patients.
- Recovery rates were 23% for non-tolerant strains versus 10% for tolerant strains (p > 0.05).
- Treatment failure occurred in 17% of patients with non-tolerant strains compared to 5% with tolerant strains (p > 0.05).
Conclusions:
- Penicillin tolerance in Group A Streptococcus does not appear to be a significant factor in acute tonsillitis treatment failure with phenoxymethylpenicillin over 10 days.
- The data suggest that other factors may be more influential in therapeutic outcomes.
- Reinfection rates were low, occurring in 3% of patients.