Related Experiment Videos
Streptococcal pharyngitis in Italian children: epidemiology and treatment with miocamycin
N Principi1, P Marchisio, A Calanchi
1Paediatric Department (IV), University of Milan, Italy.
Insights
Beta-haemolytic streptococci caused 31.9% of acute pharyngotonsillitis in Italian children. Miocamycin demonstrated high clinical (96.3%) and microbiological (85.3%) efficacy in treating streptococcal pharyngitis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Acute pharyngotonsillitis is common in children.
- Bacterial infections, particularly Group A Streptococcus, require accurate diagnosis and effective treatment.
- Differentiating viral from bacterial causes can be challenging.
Purpose of the Study:
- To determine the incidence and epidemiological features of beta-hemolytic streptococcal infections in Italian children with acute pharyngotonsillitis.
- To evaluate the clinical and microbiological effectiveness of miocamycin for treating streptococcal pharyngitis in children.
Main Methods:
- A prospective multicenter study enrolled 865 children aged 5 months to 14 years with acute pharyngotonsillitis.
- Throat cultures were used to identify beta-hemolytic streptococci.
- Miocamycin was administered to 225 children with confirmed streptococcal pharyngitis at 50 mg/kg/day for 10 days.
Main Results:
- Beta-hemolytic streptococci were identified in 31.9% of cases (26.6% Group A).
- No specific epidemiological or clinical features reliably distinguished streptococcal from likely viral pharyngotonsillitis.
- Miocamycin achieved 96.3% clinical efficacy and 85.3% microbiological efficacy in treating streptococcal pharyngitis.
Conclusions:
- Beta-hemolytic streptococci are a significant cause of acute pharyngotonsillitis in Italian children.
- Clinical differentiation of streptococcal pharyngitis is difficult, highlighting the need for microbiological confirmation.
- Miocamycin is an effective treatment option for streptococcal pharyngitis in pediatric patients.
Abstract:
A prospective multicentre study of Italian children with acute pharyngotonsillitis was carried out to determine the incidence of beta-haemolytic streptococcal infection and its epidemiological characteristics and to evaluate the effectiveness of a recently marketed macrolide, miocamycin. From February 1988 to March 1989, 865 children (aged 5 months to 14 years) were enrolled in 11 paediatric departments. Of these 31.9% had a positive throat culture for beta-haemolytic streptococci (26.6% group A streptococci, 5.3% group B, C, D or F). In 68.1% of the patients the throat culture did not yield any pathogen and the disease was considered to be probably viral. No epidemiological (age, season of occurrence, sex) or clinical characteristics (fever, pharyngeal hyperaemia, exudate etc.) could differentiate children with streptococcal pharyngotonsillitis from those with a probably viral one. Breese's score correctly identified only 19.1% of the cases with group A streptococcal infection. Miocamycin was given 50 mg/kg/day in 2 divided doses for 10 days in 225 children with streptococcal pharyngitis. The drug exhibited good clinical efficacy (resolution or improvement of acute signs and symptoms) in 96.3% of the children and a microbiological efficacy (eradication of the causative bacteria) in 85.3%.