A-streptokokkovyy tonzillit: voprosy antibakterial'noy terapii


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Abstract

Острый тонзиллит (ангина) характеризуется острым воспалением одного или нескольких лимфоидных образований глоточного кольца(чаще – небных миндалин) и принадлежит к числу широко распространенных инфекционных заболеваний верхних дыхательных путей.В настоящее время канадскими авторами разработан и апробирован на большой группе пациентов клинический алгоритм, позволяющий при первом осмотре больного предположить наличие БГСА - инфекции глотки и, соответственно, решить вопрос о назначении эмпирической антимикробной терапии при невозможности выполнения микробиологического исследования. Учитывая возможность спонтанного купирования клинической симптоматики БГСА - тонзиллита и выздоровления без каких-либо осложнений, некоторые врачи при курации таких больных совершенно необоснованно отдают предпочтение местному лечению (полоскание, ингаляции и т.д.) в ущерб системной антибиотикотерапии. Подобный подход представляется совершенно неправильным и даже вредным для больного из-за угрозы развития весьма серьезных последствий. На сегодняшний день истинные причины упомянутого «возрождения» высоковирулентной БГСА - инфекции остаются полностью не раскрытыми. В связи с этим точный диагноз и обязательная рациональная антибиотикотерапия БГСА - тонзиллита (в том числе его малосимптомных форм) стали играть еще более важную роль как в контроле за распространением этих инфекций, так и в профилактике осложнений.

About the authors

B. S Belov

ФГБУ Научно-исследовательский институт ревматологии РАМН

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