Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community
Background Acute upper respiratory infections are the most common reason for primary physician visits in the community. This study investigated whether the type of antibiotic used to treat streptococcal tonsillitis can reduce the burden by affecting the number of additional visits.Objectives To asse...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | European Journal of General Practice |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/13814788.2022.2083105 |
| _version_ | 1811215436631506944 |
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| author | Mattan Bar-Yishay Ilan Yehoshua Avital Bilitzky Yan Press |
| author_facet | Mattan Bar-Yishay Ilan Yehoshua Avital Bilitzky Yan Press |
| author_sort | Mattan Bar-Yishay |
| collection | DOAJ |
| description | Background Acute upper respiratory infections are the most common reason for primary physician visits in the community. This study investigated whether the type of antibiotic used to treat streptococcal tonsillitis can reduce the burden by affecting the number of additional visits.Objectives To assess the effect of different antibiotic treatments for tonsillitis on the number of additional primary physician visits and the development of infectious or inflammatory sequels.Methods This retrospective study included first cases of culture-confirmed streptococcal tonsillitis (n = 242,366, 55.3% females, 57.6% aged 3–15 years) treated in primary clinics throughout Israel between the years 2010 and 2019. Primary outcomes were the number of additional primary physician visits, due to any cause or due to specific upper airway infections. Secondary outcomes were the number of developed complications, such as peritonsillar abscess, post-streptococcal glomerulonephritis, rheumatic fever, post-streptococcal arthritis, chorea and death.Results Compared to penicillin-V, adjusted incidence rate ratios (IRR) for additional primary physician visits at 30–days were highest for IM benzathine-benzylpenicillin (IRR = 1.46, CI 1.33–1.60, p < .001) and cephalosporin treatment (IRR = 1.27, CI 1.24–1.30, p < .001). Similar results were noted for visits due to specific diagnoses such as recurrent tonsillitis, otitis media and unspecified upper respiratory tract infection. Amoxicillin showed decreased adjusted odds ratio (aOR) of developing complications (aOR = 0.68, CI 0.52–0.89, p < .01 for any complication. aOR = 0.75, CI 0.55–1.02, p = .07 for peritonsillar or retropharyngeal abscess).Conclusion Penicillin-V treatment is associated with fewer additional primary physician visits compared to other antibiotic treatments. Amoxicillin and penicillin-V are associated with fewer complications. These findings are limited by the retrospective nature of the study and lack of adjustment for illness severity. Further prospective studies may be warranted to validate results. |
| first_indexed | 2024-04-12T06:21:23Z |
| format | Article |
| id | doaj.art-62de0848cea240fa8b7754ffd89ffc2f |
| institution | Directory Open Access Journal |
| issn | 1381-4788 1751-1402 |
| language | English |
| last_indexed | 2024-04-12T06:21:23Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of General Practice |
| spelling | doaj.art-62de0848cea240fa8b7754ffd89ffc2f2022-12-22T03:44:17ZengTaylor & Francis GroupEuropean Journal of General Practice1381-47881751-14022022-12-0128114214910.1080/13814788.2022.2083105Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the communityMattan Bar-Yishay0Ilan Yehoshua1Avital Bilitzky2Yan Press3Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, IsraelDepartment of Family Medicine, Maccabi Healthcare Services, Tel Aviv, IsraelDepartment of Family Medicine, Maccabi Healthcare Services, Tel Aviv, IsraelDepartment of Family Medicine and Siaal Research Center for Family Medicine and Primary Care, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, IsraelBackground Acute upper respiratory infections are the most common reason for primary physician visits in the community. This study investigated whether the type of antibiotic used to treat streptococcal tonsillitis can reduce the burden by affecting the number of additional visits.Objectives To assess the effect of different antibiotic treatments for tonsillitis on the number of additional primary physician visits and the development of infectious or inflammatory sequels.Methods This retrospective study included first cases of culture-confirmed streptococcal tonsillitis (n = 242,366, 55.3% females, 57.6% aged 3–15 years) treated in primary clinics throughout Israel between the years 2010 and 2019. Primary outcomes were the number of additional primary physician visits, due to any cause or due to specific upper airway infections. Secondary outcomes were the number of developed complications, such as peritonsillar abscess, post-streptococcal glomerulonephritis, rheumatic fever, post-streptococcal arthritis, chorea and death.Results Compared to penicillin-V, adjusted incidence rate ratios (IRR) for additional primary physician visits at 30–days were highest for IM benzathine-benzylpenicillin (IRR = 1.46, CI 1.33–1.60, p < .001) and cephalosporin treatment (IRR = 1.27, CI 1.24–1.30, p < .001). Similar results were noted for visits due to specific diagnoses such as recurrent tonsillitis, otitis media and unspecified upper respiratory tract infection. Amoxicillin showed decreased adjusted odds ratio (aOR) of developing complications (aOR = 0.68, CI 0.52–0.89, p < .01 for any complication. aOR = 0.75, CI 0.55–1.02, p = .07 for peritonsillar or retropharyngeal abscess).Conclusion Penicillin-V treatment is associated with fewer additional primary physician visits compared to other antibiotic treatments. Amoxicillin and penicillin-V are associated with fewer complications. These findings are limited by the retrospective nature of the study and lack of adjustment for illness severity. Further prospective studies may be warranted to validate results.https://www.tandfonline.com/doi/10.1080/13814788.2022.2083105Tonsillitispharyngitisantibiotic treatmentupper respiratory tract infectionsprimary care |
| spellingShingle | Mattan Bar-Yishay Ilan Yehoshua Avital Bilitzky Yan Press Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community European Journal of General Practice Tonsillitis pharyngitis antibiotic treatment upper respiratory tract infections primary care |
| title | Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community |
| title_full | Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community |
| title_fullStr | Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community |
| title_full_unstemmed | Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community |
| title_short | Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community |
| title_sort | treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment a retrospective analysis of 242 366 cases treated in the community |
| topic | Tonsillitis pharyngitis antibiotic treatment upper respiratory tract infections primary care |
| url | https://www.tandfonline.com/doi/10.1080/13814788.2022.2083105 |
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