Pharyngitis(clinical scenario)?A 9 year old girl presents to her paediatrician with fever, headache, and sore throat. She has swollen, tender, cervical lymph nodes, and her pharynx is red with a gray-white exudates covering both her tonsils.
A provisional diagnosis of pharyngitis is made and throat swabs are taken or culture, sensitivity and testing. Results showed the presence of streptococcus sp.The doctor prescribes Azithromycin 300mg every 12 huors for 3 days.
was the doctor's presumptive diagnosis justified?
could the doctor's selection of antimicrobial therapy following the presumptive dianosis be criticised and is tehre any recommended alteration in the therapy and subsequent treatment plan?
alley
The doctors presumptive diagnosis was justified; the signs the patient were presenting with were classic for Strep, however this is not to only diagnosis that may have been made based on the signs and symptoms of the patient. Azithromycin, or a Z pak, is a normal antibiotic to script in a situation like this, however many doctors now feel that a Z pak does little to cure Strep completely and would suggest something stronger to make sure it is taken care of. Therapy should include staying out of public for the first 48 hours of therapy so as not to spread the strep, and motrin for the fever, headache and sore throat.
gr8mtviews
His diagnosis is justified, his choice of antibiotic is questionable.
I am of the less is more club. Amoxocillian is a better choice for a nine year old, unless he/she has strep repeatedly, which you didn't indicate. Macrolides are effective against strep, but are an expensive alternative to the penicillin based drugs. Antibiotic tolerance is too frequent these days to begin at the top of the food chain of antibiotics for strep in a nine year old.
Helpful answer below. Tonsillitis explained | Better Health Channel
Links to information about tonsillitis , including tonsillectomy.
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