Angina does not pass in any way what to do. Sore throat does not go away for a long time

It is important to understand that there is no cause for concern if the fever persists for 4–5 days after the start of therapy, but the patient's condition has improved dramatically. This means that hyperthermia is provoked by a large amount of toxins in the cells. But if the patient's well-being not only does not change for the better, but also worsens, this is a reason for an urgent consultation with a doctor and a solution to the problem.

Causes

The doctor could mistake yellow plugs in the gaps of the tonsils for festering follicles. Also, initially, the patient could hide the history data from the doctor, or the ENT simply did not want to understand this issue.

The sore throat does not go away, what to do - the patient asks, coming to the doctor's appointment a week after a successful cure. Usually, after recovery, the body acquires stable immunity, so that even the ingress of the pathogen on the mucous membrane will not cause a second disease. In rare cases, with constant contact with a patient with chronic tonsillitis, or with severe autoimmune diseases, re-infection occurs.

What to do in such a situation? To be treated again, but with the use of immunomodulatory drugs and antifungal drugs, since long-term antibiotic therapy can cause candidiasis of the mucous throat.

There are several more reasons why sore throat does not go away, lie in the improper conduct of the medical procedures prescribed by the doctor:

• Improper gargling ... Everyone knows that the rinsing procedure is the most important point in the treatment of angina, while pathogenic bacteria are washed off the mucosal surface, purulent plugs soften, mucus is washed out and inflammation is reduced. But if the rinsing is carried out too intensively, the patient gets the opposite effect, massaging the tonsils. During tonsillitis, the lacunae are filled with purulent contents, strong pressure on them does not lead to the removal of exudate, but to clogging it even deeper inside, so the sore throat is delayed, complicating the inflammation of the lymph nodes.
• Drink ... An abundant warm drink helps to remove toxins, soften mucous membranes and normalize water balance in tonsillitis. If the patient drinks hot tea or juices from the refrigerator - he achieves additional throat irritation, the same can be said about the use of sour, salty and spicy foods.
• Compresses ... To pass, with angina, they make both warming and cool compresses. Cold will relieve discomfort, and heat will improve blood circulation in tissues. If the technique of carrying out procedures is violated, sore throat will drag on for a long time, for example, after a hot compress or visiting a bath, you cannot immediately go out into the cold air or douse yourself with water, as healthy people can afford.

Usually, if all of the listed conditions for the treatment of angina are met, recovery occurs in 10-14 days, and there should be no recurrence of the pathology for at least a year.

If sore throat persists after antibiotic treatment

If the sore throat does not go away after, this may have several reasons. The first is that the causative agent of the disease is resistant to the drug, while during the course of treatment there are no positive changes in the patient's condition. Most often, the resistance of microorganisms is observed to drugs of the penicillin group (Penicillin, Ampicillin, Amoxicillin), cephalosporins (Cephalexin, Cefadroxil), less often to macrolides (Azithromycin, Sumamed, Josamycin).

There were no cases of lack of reaction to Augmentin, Sultamicillin and Amoxiclav, therefore, if treatment with these medications did not work, it was most likely that the diagnosis was incorrectly diagnosed, or the patient violated the rules for taking medications.

Why pathogens may not respond to an antibiotic:

• the initial resistance of the bacteria that caused the disease;
• misuse of antibiotics, such as gargling with them or injecting them into the nose;
• the doctor's prescription of medications that have already been used to treat angina to the patient, but they did not give positive results.

The second reason why angina does not go away for a long time after antibiotics is their unjustified use. Many patients believe that fever and sore throat are the first signs of bacterial tonsillitis, although it can be caused by a virus or fungus. Antibiotics here not only will not help, but will even aggravate the situation, therefore, if the sore throat does not go away for a month, you should not engage in self-diagnosis and treatment.

The following signs will help to distinguish viral and fungal sore throat from bacterial:

• runny nose - it is a companion of ARVI, but not sore throats, although in rare cases there are exceptions;
• white spots not only on the tonsils, but on the base of the tongue and the arches of the soft palate are a sign of a fungal infection of the throat (with angina, purulent plugs form only on the surface of the tonsils and in the lacunae).

And the third reason why angina does not go away after antibiotics is a violation of the rules of prescribed therapy. For example, when a patient willfully cancel the drug after the symptoms of the disease disappear (after 5-6 days, instead of the prescribed course of 10-14).

Also, the patient can replace the drug for internal administration with antibacterial lozenges, believing that the effect will be the same, but when such means are absorbed, no influence on the infectious agent occurs.

Another case of violation of the rules is irregular medication, when the patient drinks pills twice a day instead of three, or instead of the drug in injections, he himself replaces it with an analogue for internal administration. For example, bicillins must be injected intramuscularly, and if Azithromycin is taken orally with food, it will greatly impair absorption.

What to do

Why angina may not go away for a long time - now it is clear, it remains to find out what to do for a full cure. There are several options:

1. Go to the doctor again to identify the type of pathogen and determine the sensitivity of bacteria to the prescribed drug.
2. After changing the medication, strictly follow the instructions for use, do not replace the drug with others and do not violate the rules of use.
3. Do not start self-treatment, relying only on your own knowledge about angina - symptoms may indicate pharyngitis, chronic tonsillitis, viral or fungal infection, and it is pointless to treat them with antibiotics.
4. Increase immunity to avoid repeated infections.
5. Remember that the key to successful treatment is an integrated approach - regular and correct gargling (4-5 times a day), drinking warm drinks (water, green tea, fruit drinks from fresh berries, milk with soda) and applying compresses.

Mandatory referral to a doctor for persistent sore throat is the main condition for successful and safe treatment. Prolonged self-therapy can lead to loss of tonsils, severe heart defects and chronic kidney disease.

If the patient strictly follows the instructions, does not violate the rules for taking medications, does not self-medicate, while the symptoms of the disease appear again and again, and the doctor insists on tonsillitis and does not want to conduct a detailed examination, it is worth changing the doctor. After all, long-term use of antibiotics with an unspecified diagnosis causes mucosal candidiasis, dysbiosis and other complications, and the true cause of regular throat problems remains unclear.

Useful video about angina

Despite the fact that tonsillitis is a widespread disease, its diagnosis and treatment remain a challenge for doctors. The cause is a bacterial infection with purulent beta-hemolytic streptococcus A (BHSSA), which is present in 90% of cases. The peak incidence of streptococcal angina occurs in children aged 5-15 years. The incubation time is 2-6 days (for Streptococcus pyogenes infection). In children in the first 3 years of life, BHSSA is a rare cause of acute tonsillitis, while in adults it is responsible for 10% of cases. In other cases, other microorganisms and viruses play a role in the development of the disease. An incorrect identification of the causative agent of the disease is the main reason why angina does not go away after antibiotic therapy. The second factor is bacterial resistance.

Viral sore throat does not require antibiotics. Treatment is based on adherence to bed rest and adequate fluid intake. For sore throat, locally acting remedies are recommended. The duration of the disease without complications is up to 7 days. Antiviral medication is a treatment option. If the symptoms persist longer (do not go away up to two weeks), we can talk about the addition of a bacterial infection. In this case, in addition to clinical examination, it is necessary to conduct a study of the sedimentation of erythrocytes and urine for the presence of protein. If the results do not indicate resolution of the disease, blood tests, ASLO (antibodies against streptolysin O) and (if necessary) microbiological tests are performed. A control throat swab is performed in patients with prolonged symptoms of angina, relapses of the disease, in the case of a history of rheumatic fever, a high risk of recurrence (done within 1-2 weeks and, if necessary, after a month).

Resistance

The next factor responsible for the fact that angina does not go away after antibiotics is the resistance (resistance) of the pathogen to the drug used. Bacteriological resistance of streptococci after treatment of acute streptococcal tonsillitis (in particular, Penicillin) is demonstrated in 25% of patients, about half of them suffer from persisting clinical signs of the disease. Detection of asymptomatic β-hemolytic streptococci usually does not require further therapy. Continuation of treatment is advisable in people with recurrent episodes of infections caused by this pathogen, with the development of complications of angina (rheumatic fever) or infection of other family members.

Read also: Angina without fever: causes, symptoms, treatment

Recurrent tonsillitis

Recurrent (recurrent) tonsillitis can be a therapeutic problem. The choice of the optimal treatment procedure is individual. If the sore throat does not go away after the main treatment, it is necessary to look for possible allergies, permanent transmission of infection, and a decrease in the body's immunity. It is advisable to solve the problem in cooperation with different specialists.

The number of relapses is reduced by repeated therapy, i.e., antibiotic treatment within 2-3 days after the symptoms of the disease recede, when prolonged antigenic stimulation of the macroorganism and the generation of antibodies that protect against further infections of the same species or serotype are possible.

In case of relapses in angina, the use of antibiotics that are active against microorganisms that produce β-lactamase helps. With recurrent streptococcal infections, the use of penicillin is impractical - it will not show effectiveness due to the high resistance of the bacteria; the antibiotics mentioned, active against β-lactamase-producing organisms, are recommended:

• 2nd generation oral cephalosporins;
• protected aminopenicillins;
• new generations of macrolides and clindamycin.

Important! All of these groups of drugs act by a mechanism different from penicillins and cephalosporins, and are well concentrated in the tissues of the tonsils.

Immunomodulatory therapy, adenotomy (a procedure more common in children), and targeted repetition of antibiotic treatment in the event of a relapse of pathogenesis may be helpful.

The next alternative for the treatment of recurrent episodes of hemolytic streptococcal infections (with the exception of tonsillectomy) is the long-term use of low doses of Penicillin (prophylaxis). But this approach is not often used in our country. If the tonsil infections persist, the pain and redness of the throat after a sore throat does not recede, tonsillectomy is recommended.

Important! While tonsillectomy was performed on a uniform basis in the 1950s, today the approach to treating angina and therefore tonsillectomy has changed, especially in children.

When deciding on the advisability of tonsillectomy, many factors are taken into account: the severity of the infection, age, etc. Tonsilotomy, partial removal of the tonsils, is not recommended in case of recurrent inflammation or prolonged persistence of tonsillitis symptoms, it is intended only for cases of free-flowing hyperplasia of the tonsils, causing difficulty in swallowing and breathing.

Read also: Angina: definition, origin, treatment

Complications

Despite the long-term persistence of symptoms of angina, taking antibiotics somewhat reduces the inflammatory complications of the disease. Otolaryngologists are more common with local complications. They are caused by the spread of the infection into the tonsil capsules and include parathyroid phlegmon and abscesses. In the absence of treatment for prolonged or recurrent sore throat, there is a risk of more severe complications that require specialized treatment. Such complications are caused by the invasion of the infection into the deep cervical spaces with thrombophlebitis of the jugular vein, mediastinum and sepsis. Common complications are the manifestation of a post-streptococcal immune response with a wide range of manifestations and consequences. They are classified as inflammatory and non-inflammatory.

Basics of treatment

While most patients with acute tonsillitis are treated empirically on the basis of clinical research, it is important to conduct further research to accurately determine the pathogen and its possible drug resistance in the question of what to do if the angina does not go away after the main therapy. The goal of treatment is to suppress the infection, the persisting clinical symptoms, and prevent potential complications.

Topical treatment is directed at disease other than streptococcus. Antimicrobial drugs, local antiseptics, disinfectants, local antibiotics, to which the microorganism is not resistant, are used.

Systemic treatment includes antimicrobial drugs, vitamins, antipyretics.

The first line drug is Penicillin, which is used for 7-10 days. During this period, it is important to conduct microbiological examinations. If there is no improvement in the general and local condition after the start of treatment (up to 3-4 days) or microbiological examination has confirmed the resistance of the microbial agent to Penicillin, the antibiotic should be replaced.

The main problem in determining the appropriate treatment is to meet the requirements based on the infectious agent. Inflammatory changes in the mucous membranes are most often of an infectious origin, where the main causes are viral, bacterial or fungal infections. These changes are often secondary, caused by previous mechanical, thermal, or chemical damage to the tissue. Sometimes inflammation is associated with secondary lesions due to tumor changes. In addition, the persistence of symptoms after treatment of angina may be associated with diseases of the proximal or distant organs, systemic diseases, and manifestations of intolerance to the drugs taken. An aggravating factor is the virulence of pathogen strains, the degree of cytotoxicity, the immune status of a sick person, and the presence of anatomical abnormalities in the respiratory tract.

What is the reason for this and how you can overcome the persistent course of angina, we will consider below.

Causes and mechanisms

Those who do not have sore throat want to know why this happened and what needs to be done to recover. It should be understood that the second aspect is a logical continuation of the first. Any pathological process or malfunction in the body has its origin, and its clarification is the most important component of medical care. You cannot hope for quality treatment without understanding the cause of this or that phenomenon. And the source of problems with a protracted course of angina may lie in this.

In the overwhelming majority of cases, inflammation of the tonsils is caused by group A beta-hemolytic streptococcus.But the causative agent of angina can also be completely different microbes:

It is worth saying that the cause of changes in the tonsils is sometimes hidden in hematological pathology (leukemia, agranulocytosis) or is associated with immunodeficiencies (including HIV infection). And antibiotics are not always required. In many of the situations listed, they will generally be ineffective, and their reception will only delay the process and complicate it. Therefore, the first condition for curing a sore throat - an unambiguous finding out of the cause - must always be met. Otherwise, the disease can persist up to a month.

Finding out the cause of the inflammation of the tonsils is a key aspect of providing medical care for angina, which determines all further measures.

Symptoms

A correctly established diagnosis is the basis for further measures. And half of it consists of clinical examination data. Therefore, finding out the reason for the ineffectiveness of the treatment of tonsillitis begins with a second medical examination. The prolonged course of inflammation should alert the patient and force him to come for an extraordinary consultation. As with the initial visit, the specialist will establish complaints and objective symptoms, but will do so with increased attention.

During the survey, the doctor pays attention to how the symptoms have changed since the last visit, they have become less pronounced or, conversely, worsened. It is necessary to re-evaluate all the same signs of acute inflammation:

If the angina does not go away for a long time, then we can assume its transition to a chronic stage - tonsillitis. This is facilitated by a sluggish infection in the nose and oropharynx (sinusitis, pharyngitis, caries) with impaired local immunity. Then, among the local signs of inflammation, the following will be present:

• Pus or plugs in gaps.
• Changes in the edges of the palatine arches (persistent redness, swelling, roller-like thickening).
• The adhesion of the tonsils with the arches.

In chronic tonsillitis, symptoms of allergization of the body appear, associated with the toxic effect of microbial antigens. These include joint pain, heart pain, lower back aches. General violations can be registered outside exacerbations.

But besides the transition to a chronic form, there is another option, when the symptoms not only persist, but also worsen. We are talking about the complications of angina. These include:

• Paratonsillitis.
• Abscesses (paratonsillar, perio- and retropharyngeal).
• Cervical lymphadenitis.

Most often, inflammation of the tissue surrounding the amygdala occurs. The process is usually one-sided. Against the background of treatment or already during the recovery period, pains in the throat again occur, but they are one-sided and much more intense, give to the ear and neck, and may increase when the head is turned (due to muscle involvement). Incomplete opening of the mouth (trismus) is characteristic, the body temperature rises, the general condition is relatively difficult. Then an abscess is formed.

When the inflammation of the tonsils has not passed after the prescribed therapy, local signs and the general condition of the patient should be re-evaluated in order to exclude complications and the transition to a chronic form.

Additional diagnostics

Those patients who have a sore throat that do not go away for a long time need further examination. It is necessary to re-evaluate the nature of the inflammation and identify the pathogen that has become its source. To do this, the doctor will refer the patient to diagnostic procedures:

• General analysis of blood and urine.
• Blood biochemistry (markers of inflammation, immunogram).
• Pharyngeal and nasal swab (microscopy, culture, PCR).
• Determination of the sensitivity of pathogens to antibiotics.
• Serological tests (antibodies to infections).
• Pharyngoscopy.

It is necessary to recall once again the importance of laboratory verification of the microbes responsible for inflammation in the tonsils. Only after receiving the result can you understand which pathogen to act on. Without this, it is difficult to hope for the complete success of therapy.

Treatment

The next step is treatment. And here errors are possible, leading to the fact that angina can persist even for a month after the onset. They are observed by both the patient and the doctor. If doubts about the competence of a specialist are discarded in advance, then you need to follow his recommendations in everything and not deviate from the prescribed therapy regimen. It is known that acute inflammation of the tonsils should be treated with antimicrobial agents for at least 10 days. And some patients do so that, only noticing an improvement in their condition, they stop taking drugs. Here sore throat comes back after antibiotics.

But too long antimicrobial therapy can also run the risk of getting into trouble. It should be remembered that together with pathogenic bacteria, representatives of the normal flora of the oropharynx also die, which turns into candidiasis. The tonsils turn red again and become covered with a white coating, and sore throat may return. Then you will have to fight the fungal infection and restore the body's natural biocenosis.

One of the reasons for the ineffectiveness of therapy can be called the fact that the results of bacteriological examination have to wait for a long time (5-7 days). But during this period, the patient should not be left without treatment. Even according to clinical protocols, doctors first prescribe broad-spectrum drugs. But no one in this case, no one will confirm the sensitivity of microbes to them. And if we take into account the likelihood of viral sore throats, then the treatment may well not give the expected result.

The effectiveness of the treatment of angina depends on several factors: the correct selection of drugs, compliance with the dosage and the duration of their administration.

Conservative

Thus, the therapy of angina must meet several criteria: timeliness, adequacy and completeness. The appointment of certain drugs is predetermined by the diagnostic results and is carried out only by a doctor. And no self-medication is allowed. Given the source of inflammation and the mechanisms of development of angina, the following drugs can be used in complex treatment:

• Antibiotics (Augmentin, Sumamed).
• Antiviral (Laferon, Zovirax, immunoglobulins).
• Antifungal (Futsis, nystatin).
• Non-steroidal anti-inflammatory drugs (Ibuprom).
• Immunomodulators (T-activin, Polyoxidonium, Immudon, Derinat).
• Vitamins (C, E, B, K).

In the treatment of chronic tonsillitis, a combination of local and general strengthening therapy is of great importance. Among the conservative methods, washing the lacunae of the tonsils and further lubricating them with Lugol's solution is often used. Among non-drug methods, physiotherapy is used (UHF therapy, UFO, ultrasonic aerosols).

Surgical

In some cases, you even have to resort to surgical treatment. If the sore throat does not go away for a long time due to the development of complications, then the focus of purulent inflammation should be eliminated. And it is not possible to do this without surgical intervention. Even against the background of systemic antibiotic therapy, an abscess should be opened.

With frequent exacerbations of chronic tonsillitis, there are also indications for surgery. It can be performed using a gentle technology - cryotherapy (freezing the surface layer of the tonsils) - or a radical method (tonsillectomy). But what exactly is best for a particular patient, the doctor will determine.

Thus, to ensure the effectiveness of therapy for angina, it is necessary to strictly adhere to the rules for the provision of medical care at all stages. Setting the only correct diagnosis with identification of the pathogen and determination of its sensitivity to antimicrobial agents, timely and adequate treatment are the main factors that ensure the success and recovery of the patient.

What to do if sore throat persists

If the sore throat persists, it is better to stop the useless treatment. Be sure to consult with your doctor and ask him to prescribe other drugs for you. There are many tools that give good results, but not every specialist is able to make a competent appointment.

Treatment of sore throat sometimes does not give a positive result, several factors can affect this. Symptoms persist for 2 weeks or more, why is this happening?

Causes of prolonged sore throat:

1. Antibiotics are incorrectly selected. The causative agent was immune to them.
2. The patient was not taking antibiotics.
3. The doctor made a mistake with the diagnosis.
4. The patient did not listen to the words of the attending physician.

If at least one of the points applies to you, then you need to take action. There is no need to wait, the improvement from inaction will not come.

To recover, you first need to go to the hospital. The doctor will prescribe a course of antibiotics that will neutralize the pathogen and prevent complications from appearing. Such drugs can be in different dosage forms: solution, tablets, powder, capsules. They must be taken with a prescription from a therapist. It is forbidden to prescribe treatment on your own.

In addition to drugs, you need:

1. Monitor nutrition, it must be balanced. Eat more vegetables and fruits. Drink plenty of fluids to flush out toxins from your body. Give preference to still water, herbal and green teas, compotes, fruit drinks, natural juices. Everything is drunk warm.
2. Gargle with decoctions of medicinal herbs and other special solutions to cleanse the tonsils from pus, plaque and mucus, relieve inflammation and disinfect.
3. Make warming alcohol compresses.
4. Do not overcool or irritate the throat with cold liquid or food.
5. Walk more in the fresh air and ventilate the room.
6. During treatment, do not drink alcohol and quit smoking, as the smoke will irritate the sore throat.

Keep in mind that if you do not get better from treatment and adherence to all recommendations for two weeks or more, then you should think about changing your doctor or even clinic.

If you adhere to all the rules, do not interrupt treatment and lead a healthy lifestyle, then your illness will not last long. An integrated approach is the main thing in the treatment of angina.

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Why does angina not go away after antibiotics and what should the patient do?

Angina after antibiotics occurs repeatedly (or does not go away at all) in several cases:

1. The causative agent of the disease is resistant to antibiotics. This is a normal situation when taking drugs of the penicillin group, more rare for cephalosporins and macrolides. In this case, angina does not go away after antibiotics at all, and the patient does not feel relief;
2. The diagnosis was incorrectly diagnosed and an exacerbation of chronic tonsillitis was taken for angina. Sometimes even tonsillitis itself with plugs in the tonsils is called angina by patients;
3. Again, an error in the diagnosis of the disease and an attempt to treat fungal or viral tonsillitis or pharyngitis with antibiotics. Antibiotics do not act on fungi or viruses, and such a "sore throat" will not pass when used;
4. Violation of the rules for the use of antibiotics. For example, if the patient stopped taking them on the third day of treatment, when he felt better, it is quite likely that the disease will recur again or develop chronic tonsillitis. In this case, repeated angina after antibiotics can develop after a few weeks or months, in extremely rare cases - after a few days;
5. Re-infection soon after treatment. A very rare, almost exceptional case.

It is important to understand that if, with angina after antibiotics, the temperature simply does not drop, but the patient's general condition is normalized, this is not a cause for concern. The temperature in many cases remains high not so much because of the activity of the causative agent of the disease, but because of the presence in the tissues and blood of a large amount of bacterial cell debris and toxins. It is normal if the temperature, when using effective antibiotics, remains elevated for a week, but at the same time it should drop to subfebrile values \u200b\u200b(37-38 ° C), and the general condition of the patient should be normalized. If antibiotics do not help with angina, the patient will not get better.

Normal body temperature in a patient with angina is 1-2 days after the start of antibiotics.

The patient feels a noticeable improvement in his condition after 2-3 days. You should not expect that in 3-4 hours after taking the medicine, the sore throat will pass.

In general, if all the rules of antibiotic therapy for angina are followed, there should be no situations when antibiotics do not help. These cases occur due to the fact that the doctor prescribes a remedy without finding out the pathogen and its resistance to various drugs, either in case of errors in diagnosis, or in violation of the rules for taking funds.

Staphylococcus aureus is a bacterium that very often has resistance to many antibiotics, including penicillins.

How to determine the specific reason why angina does not go away after antibiotics or reappears, and what to do in a particular case?

Antibiotic resistance of the pathogen

In this case, both situations are possible:

1. The disease does not go away after antibiotic therapy;
2. The disease goes away, but a repeated exacerbation of tonsillitis soon develops. The primary or previous exacerbation ends, since this is normal for angina (it cannot be chronic), and the next one develops against the background of a weakened immune system, accidental re-infection and other reasons.

But in general, the insensitivity of the causative agent of angina to an antibiotic is manifested precisely by the absence of any effect from taking the drug.

Staphylococcus aureus surrounded by metabolic products. Among them - including enzymes that break down and deactivate penicillins.

Note Most often, antibiotics of the penicillin group do not help with angina (pure amoxicillin, ampicillin, phenoxymethylpenicillin, penicillin and bicillin in injections) - up to 25% of cases in different countries, less often - cephalosporins (cefadroxil, cephalexin) - or in about 8% of cases both of these groups at the same time (about 5% of cases), and very rarely - macrolides (erythromycin, azithromycin, josamycin). There are no known cases of resistance to inhibitor-protected drugs (Augmentin, Amoxiclav, Sultamicillin), therefore, if angina is treated with them and the treatment does not give an effect, there is an error in the diagnosis or violation of the rules for taking the drug.

The reasons for the resistance of the pathogen to an antibiotic:

1. Initial resistance of the bacterial strain with which the patient was infected;
2. Violation of the rules of antibiotic therapy: local use of systemic drugs (for example, instillation of antibiotics in the nose with a runny nose, gargling with them);
3. The use of drugs with which this patient's angina has already been treated before and the treatment did not give a result.

The latter case, by the way, is a flagrant violation of the rules of antibiotic therapy, which doctors sometimes allow. Situations are known when a doctor in the old fashioned way prescribes penicillin injections to a patient with angina, not paying attention to the fact that in the same patient the disease has already been treated with such injections several times, which in a particular case do not help.

First of all, by the absence of changes in the patient's condition, sometimes by its deterioration. In medical practice, it is generally accepted that if no noticeable changes occur within 48 hours after the start of use, the antibiotic must be replaced, or the diagnosis must be rechecked.

The sodium salt of benzylpenicillin is an outdated antibiotic that is ineffective in every fourth case.

What should the patient do?

Visit a doctor. If he does not change the antibiotic, does not take a swab from the throat for analysis to determine the sensitivity of bacteria to drugs, but simply says that you need to wait - to go to another doctor. After changing the drug and adjusting the treatment, the patient must strictly adhere to the doctor's instructions for taking the drug.

Error in the diagnosis and treatment of chronic tonsillitis

This situation is characterized by repeated exacerbations of the disease after antibiotic therapy. Symptomatically and clinically, they resemble tonsillitis, but a specialist can distinguish them according to individual signs. Exacerbations of chronic tonsillitis usually proceed easier and faster than sore throats, and therefore, regardless of antibiotic therapy, the patient quickly feels relief.

Also, sometimes chronic tonsillitis itself is considered a sore throat by patients. In this case, a picture is also likely when antibiotics do not affect the course of the disease and the appearance of the tonsils.

Typical appearance of tonsils in chronic tonsillitis. The stones are clearly visible.

It is important to understand that chronic tonsillitis can also be treated with antibiotics. But in addition, with it, it is important to flush the lacunae of the tonsils, strengthen the immune system, and eliminate factors that contribute to the exacerbation of the disease.

Washing the lacunae of the tonsils in the clinic

Causes of diagnostic errors:

1. The similarity of the manifestation of exacerbation of tonsillitis and tonsillitis;
2. The patient's refusal to inform the doctor about the history data, or the doctor's unwillingness to deal with this issue.

As a rule, if repeated tonsillitis after antibiotic therapy occurs constantly and at short intervals - a week, two weeks, a month - we are talking about chronic tonsillitis. Normally, this disease does not occur more often than once a year. In addition, if a patient has yellow plugs on the tonsils (which are often confused with suppurative follicles in follicular tonsillitis), and the tonsils themselves are enlarged all the time, this also speaks of a chronic disease.

Plugs in the tonsils turning into solid formations.

What should the patient do?

If the treatment of chronic tonsillitis with an antibiotic was prescribed by a doctor who confused the disease with angina, it is worth finding another doctor. Otherwise, there is a risk of treating the disease for several years, and in the end you will still go for an operation and lose your tonsils. Such cases do occur.

If the patient has diagnosed himself with "sore throat" and decided to drink antibiotics with it, stop playing doctor and turn to a good specialist. Otherwise, you can not only lose your tonsils, but also acquire severe heart defects and chronic kidney disease.

Antibiotic treatment of viral and fungal diseases

This is one of the most common reasons why antibiotics do not help with angina. Many patients diagnose the disease at home and believe that if the throat hurts and the temperature rises, it is sore throat and it needs to be treated with antibiotics. Moreover, in many cases, viral tonsillitis and pharyngitis manifest themselves with similar symptoms, on which antibiotics will not work.

Throat when infected with the Coxsackie virus

Also, many patients look down the throat, see white spots in the throat and decide that this is definitely a purulent sore throat, although we can talk here about fungal pharyngitis. Antibiotics with it not only will not help, but can even aggravate the situation.

In many cases, only a doctor can distinguish viral and fungal diseases of the throat from sore throat. Moreover, sometimes it is difficult even for a specialist to differentiate by external signs, for example, catarrhal sore throat from viral pharyngitis, or tonsillomycosis from lacunar sore throat. In general, the distinguishing features here are:

1. Runny nose - with angina, it does not develop, with a viral disease, it is the norm. But there are exceptions;
2. The spread of white spots beyond the tonsils - to the palate, palatine arches, the base of the tongue. In this case, we are talking about a fungal infection of the pharynx, since with angina, pus is localized only on the tonsils.

In addition, if angina does not go away after antibiotics such as Augmentin, Amoxiclav, Flemoklav Solutab, erythromycin or azithromycin (not to mention the expensive latest generation drugs - Vilprafen, Timentin), we are talking about a viral or fungal disease. These antibacterial drugs for angina work almost always.

A fungus of the genus Candida, which thrives on antibiotics.

What should the patient do?

Stop self-diagnosis and self-medication and seek medical attention. If the disease is viral, symptomatic treatment is prescribed, if it is fungal, antifungal agents are taken. If a doctor has prescribed an antibiotic, after two days of unsuccessful use of antibiotics, he should clarify the diagnosis and prescribe the correct treatment. If this does not happen, you should see another doctor.

Inappropriate use of antibiotics

In many cases, gross violations of the rules of antibiotic therapy are also the cause of repeated exacerbations or the fact that angina does not go away after antibiotics at all. For instance:

• Interruption of taking antibiotics earlier than the period indicated by the doctor. The minimum treatment period is 7 days, the normal one is 10-15. Only azithromycin can be taken for 5 days, and sometimes for 3 days, but in the latter case, the incidence of repeated exacerbations of the disease is high;
• Replacement of systemic antibiotics with local ones. Some patients believe that if they suck lozenges or antibiotic pills with angina, the result will be similar to the systemic intake of these funds. In fact, when the tablets are absorbed or gargled with antibiotics, no effect on the infection occurs, and the disease will definitely not go away with such treatment;
• Irregular intake of antibiotics, or taking them in violation of the instructions. For example, when taken simultaneously with food, azithromycin is absorbed into the blood much worse and may not act on the disease; bicillins should be injected only intramuscularly. Due to ignorance of these features, drugs may not work as they should.

This situation is most typical for adult patients who do not really get treated, but buy an antibiotic as directed by a doctor and drink it when they accidentally remember it.

Just from memory. If the patient does not remember when he last took the drug, in what quantity, and what the doctor said about the appointment, most likely there were violations of the rules of admission.

A container reminding the owner of the time of taking the pill.

What should the patient do?

Take the drug according to the instructions. If the situation does not improve, or the disease reoccurs, you need to go to the doctor for a second diagnosis (perhaps we are already talking about chronic tonsillitis) and adjust the treatment.

Re-infection with sore throat

This situation is almost hypothetical. After a successful cure of sore throat, the body remains sufficiently stable immunity, the number of cells of the immune system in the tonsils and antibodies in the blood remains high for a long time, and repeated exposure of the pathogen to the tonsils will not cause disease. In addition, the causative agent of sore throat itself needs to be picked up somewhere else. Exceptions are situations when the patient has an immunodeficiency or constant work with patients (for example, doctors, internship students).

Macrophages are cells of the immune system that purposefully hunt and eat bacteria.

This situation is quite typical: after taking antibiotics, the angina quickly ended, the patient recovered, he did not have any signs of chronic tonsillitis. After a while, a typical angina developed. Again, we are talking here about her, and not about viral lesions of the throat - they can develop after a successfully cured sore throat.

What should the patient do?

Treat sore throat again. Necessarily - with the advice of a doctor, since repeated antibiotics can provoke the development of a fungal disease. And in general, this situation is non-standard and the doctor must make sure that the recurrent illness is exactly angina.

With any problems in the treatment of angina, you need to contact a specialist.

• Recurrent angina after antibiotics, or simply the lack of effect from the use of these funds - a consequence of violation of the rules of antibiotic therapy;
• Only a doctor can determine why antibiotics do not help completely get rid of the disease;
• If sore throat does not go away after antibiotics, this is a signal that everything possible must be done to cure the disease. In this case, the patient must see a doctor. Otherwise, the disease may become chronic or complications may develop.

Read on:

Flemoxin does not help with angina in two cases: Angina is caused by a pathogen resistant to amoxicillin, the active substance of Flemoxin. ...

Pus on the 9th day of purulent tonsillitis should not be present on the tonsils. Normally, the abscesses disappear already on the 4-5th day of the illness, and the sore throat itself passes in.

A rash after taking antibiotics for angina is not a frequent phenomenon, but it is not extremely rare either. If you or your child gets sprinkled after a sore throat and a.

Hello, I have a sore throat, I pierced 5 injections of ampicilicin for a million, it seemed to go away, but after 5 days it was repeated, but another tonsil became inflamed and festered, drank ampicillin for 4 days and amosin pus receded, but now it has reappeared. I was told that the treatment was not completed and the pills I drank were not too strong. And it is also inflamed and it will fester back again. Can you give me an ampicillin 10 days to be punctured to heal everything for sure?

Hello. Whether ampicillin will help you specifically can be said for sure only by the results of bacteriological research. Chances are, if you haven't completed your previous treatment, this antibiotic won't really help. You need to go to the ENT hospital for an appropriate test.

I am in no hurry to drink an antibiotic. If sore throat at the initial stage is enough for me to take Tonsilotren for a goal. At the first symptoms of sore throat, it helps well in autumn. I was convinced of this when I treated my throat.

Good afternoon. I had a purulent sore throat. The doctor prescribed an antibiotic. I stabbed Ampitsilin for 7 days. After 4 days I have pus on my tonsils again. I called the doctor. She advised Azithromycin. I drank 3 tablets. It took 3 days and I have a sore throat again. .And it seems again that something is wrong with the throat. What to do? There is not much time to go to the doctors. Just got a job.

Hello. After two strong antibiotics, you may well develop a fungal infection of the throat. It is unlikely that the causative agent of sore throat is resistant to antibiotics of two completely different classes, although theoretically this is possible. You need to take a throat swab for microflora analysis. According to its results, the doctor will be able to say for sure, firstly, whether you have completed the sore throat, and secondly, what is your problem now, and thirdly, what you need to be treated with now.

hello, during the examination, my daughter was told sore throat, treatment was prescribed Desefin, ibufen, lugol, streptrcid. the temperature has been decreasing and then rising for more than two weeks. I don't want to go to the doctor, they don't really know

Hello. You need to find a good doctor. Otherwise, the problem cannot be solved. The doctor should direct the child to pass the necessary tests, accurately diagnose dianosis and, most importantly, explain how this or that remedy that he prescribes works.

Hello! Diagnosed with angina, white plaque on the tonsils, inflamed cervical lymph nodes, a child of 18 years old, prescribed flemoxin solutab (drank for 2 days), after examination by an ENT, flemoclav solutab, temperature for the first 2 days up to 39, in the following. 3. There are no visible improvements. Constant nausea. What to do? What tests to pass to determine the exact diagnosis or resistance to the penicillin group? Can the antibiotic be changed? What day should the improvement come?

To identify the resistance of the pathogen, a throat swab must be taken for bacterial analysis. According to the treatment protocol, if there is no improvement within 3 days after starting antibiotics, the drug is changed. But only a doctor can change the antibiotic in order to choose a safe remedy. Moreover, in your situation, this can be done only after receiving the results of bacterial sowing.

Good afternoon. The child is 2.9 years old, the second time in a month and a half the diagnosis of tonsillitis and therapy with aamoksiklavom, I have a question when taking amoxiclaa according to the scheme 250 mg 4 times a day, on the third day the tonsils increased even more, accompanies a runny nose and sputum leaves, which means amoxiclav does not help ? There is no temperature, the doctor suggested that the last time we did not cure tonsillitis and prescribed amoxicl again. I also gave directions for a smear from the pharynx to staphilocks and bl, delivery on the 3rd day of taking antibes, is there any way to take a smear now?

Hello. A runny nose and repeated tonsillitis are indications of a viral infection. You cannot use Amoxiclav with it. It makes sense to take a smear and consult another doctor with its results (and even before receiving them).

Hello, I had purulent lacunar sore throat, I was in the hospital with Ceftriaxone inside the vein, and I received Azithromycin for 5 days. I have thrombocytopenic purpura and a 9 week pregnancy. Therefore, I refused penicillin inside the muscle. Now a week goes by 2 points of abscesses have appeared, sore throat, dryness. I rinse with furatsilin I don’t know what to do ...

Hello. You know, anything can happen. Perhaps the process has begun to become chronic, perhaps a fungal infection has joined. You need to take tests and diagnose the disease with a doctor. Your doctor will tell you if you can get penicillin injections.

Hello, the doctor prescribed a flemoklab doctor for a sore throat. On the second day after taking the condition, the condition worsened, the abscesses on the tonsils got out, she went to the doctor, she said to continue to drink the antibiotic, can the flemoclab Solyutab provoke a fungal sore throat, I am still being treated for more than a month for a smear from the throat, the doctor has not sent during and now the whole polyclinic is repeating after taking so many drugs and antibiotics, a smear will not show you anything, but what should I do, I already do not know the temperature is 37.37.2

Hello. Flemoklav can provoke fungal sore throat. There is no point in taking antibiotics for more than a month, standard tonsillitis does not last so long. Consult a doctor from another clinic, perhaps you really need to take a smear and examine the microflora.

Hello, the gynecologist attributed Unidox, on the sixth day my throat ached and a white coating appeared on the tonsils, could this be a sore throat?

Hello. In your case, it can be either a sore throat or fungal pharyngitis. What exactly you have can only be said by a doctor who will directly examine your throat.

Hello. Throat ached and the temperature rose to 38 degrees in the morning it seemed to normalize, but the sweating remained weak, I went the next day as white specks appeared on the megdalins, to Laura, the ENT sent to an infectious disease specialist, prescribed the antibiotic amsef, loprax tablets, rinse with sage chamomile infusion ... for 5 days, immediately on the second day of admission, it stopped hurting, and on the third megdalina became clean, 5 days passed I thought that everything was cured for two days, I just rinsed it, at night again the temperature, I see white specks appear again on the megdalina. the doctor ascribes to the cyptriaxone injections for four days and to rinse, inhalip…. They pierced me at home for four days, my throat does not hurt, but still there are little white specks on the megdalins, food is again attributed to the tablets Cedoxin took cephalexin, so I take the third day and rinse with chlorophyllip and soak the tablets and still eat 3-4 teats on the skin megdalini, and on the throat such red pukhirtsy on one there is a white tsyatochka, megdalinis are no longer swelling and not only red there are red sores on them (a bit) and a couple of specks, but still somehow waddle like a lump in the throat. By the way, they did not take a smear, the diagnosis is exacerbation of chronic tonsillitis , although how could it become chronic if I had a sore throat three years ago, then I was sick for a week and a half, since for the first days the doctor prescribed only a rinse and then an antibiotic and everything went on the mend! Today I have been undergoing treatment for two weeks already, doctor can you tell me how to be, what to do, I am very afraid of complications that can jump to the heart, liver and kidneys! Thank you in advance!

You have now been successfully treated with an antibiotic and are not likely to develop complications. Now it is difficult to say whether you really have chronic tonsillitis or not. This disease may not make itself felt for more than a year, and then manifest itself as an exacerbation, similar to a sore throat - like yours. It will be possible to establish exactly whether you have chronic tonsillitis in a week or two, when all the symptoms of exacerbation have ended. If plugs remain on the tonsils, and a smear shows the presence of an infection, it will be necessary to additionally be treated for chronic tonsillitis in order to avoid the development of exacerbations in the future.

For now, get well and do not be afraid: everything that had to be done, you and the doctors have already done.

Or maybe I have a herpes sore throat? By the way, two days before the first symptoms on my face, I had herpes, and in school years and herpes on my lips I was not excretory!

Hello, I have a big problem, in general, my throat does not hurt, 3-4 years there was something similar to a sore throat, but I did not pay attention to the pier itself, rinsed my throat with soda and salt, the symptoms disappeared. But at the same time, unpleasant sensations started in urete, the tests showed that everything was clean. It took 3 years, and everyone who kissed with me, ate common dishes, spoons and forks) began to get sore throat, everyone had symptoms such as I had 3 years ago. I have on the back of the throat purulent pricks, and continue down the larynx. I drank antibiotics, by the way, I felt much better, but again I thought about it, and ate my own dishes, did the purulent pricks return? Please tell me what needs to be done to solve this problem once and for all?

Hello. "Purulent pimples" in the larynx do not look like sore throat or chronic tonsillitis. According to your description, I cannot say what kind of illness you have. This means that I cannot recommend treatment. The only thing I can recommend to you is to see a doctor. Only he will be able to diagnose the disease and determine how it can be treated. Until you have found out the nature of the disease and have not determined how you can destroy its pathogen, you will not solve the problem once and for all.

Hello. The son is 2 years old. Recently I had a sore throat with high fever and was injected with ceftriaxone. A week later, the son began to squint while swallowing food. We looked at the throat, it is red and everything is covered with singing clothes, but there is no temperature and the child is active. The doctor prescribed clarithromycin. But I have a suspicion that this is not a sore throat, but fungi. Because in 2 months we injected with an antibiotic 2 times.

Hello. In general, pain syndrome with fungal pathologies does not always manifest itself. But if it really is a fungus, then antibiotics can even aggravate the child's condition. If you are in doubt about the correctness of the doctor's instructions, see another specialist. Just be sure to show the child, and do not consult verbally. In your case, only examination and special tests will help to accurately diagnose the disease.

There was purulent sore throat for half a day, the temperature of work was 38-39. On the second day, the raid passed. I gave up the antibiotic early and already on the 12th day the throat hurts and from the tonsils in 3 days the alignment of pus. How dangerous is it?

Perhaps your angina develops into chronic tonsillitis. Normally, on the 6-7th day, the abscesses are resolved and the pus from the tonsils no longer expires. If this happens on day 12, foci of infection have formed there. In the future, purulent plugs will form here, which will cause bad breath. With a high probability, in the presence of such plugs, sore throat-like relapses will occur every few months, they can cause complications from the heart, kidneys and joints. The development of abscesses and the need to remove the tonsils are also possible. How dangerous it is is up to you to decide.

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Angina does not go away: what to do for adults

After antibiotics, angina does not go away at all or reappears only when certain conditions exist.

For example, a pathogenic agent can develop resistance to a drug. This phenomenon is quite typical for antibacterial drugs of the penicillin series. But for macrolides and cephalosporins, this is completely uncharacteristic.

So, when the pathogen gets used to the antibiotic, angina may not go away at all and the patient does not experience any relief from the therapy.

Another situation - the diagnosis was made incorrectly, and the doctor mistakenly took an exacerbation of chronic tonsillitis for a sore throat. Often, patients themselves call tonsillitis angina.

Another mistake is made by the doctor if he begins to treat pharyngitis, tonsillitis of viral or fungal origin with antibacterial drugs. The fact is that antibiotics have no effect on viruses or fungi. Therefore, both of these diseases will not go away with antibiotic treatment.

Angina does not go away even if the patient is undisciplined and quit taking medications as soon as he felt significant relief. Any therapy has its own specific course, which must be completed completely.

Otherwise, a few weeks or a month after stopping antibiotics, angina may return again. If the course of treatment was followed completely, a rapid relapse of the disease is practically excluded.

What to do if temperature persists for a long time after treatment?

The patient should bear in mind that after taking antibiotics, the temperature with angina can persist for quite a long time. However, if the general condition of the patient has returned to normal, nothing needs to be done.

In many cases, the body temperature remains high not due to the activity of the pathogen, but due to the presence in the blood and tissues of an excessive amount of toxic substances and the remains of bacterial cells.

Therefore, if the temperature remains elevated within a week after taking antibiotics, this is quite normal, but:

1. its indicators should still go down to subfebrile condition;
2. the general condition of the patient should be normalized;
3. the patient ceases to feel a sore throat.

If these changes are not observed, then the antibiotics did not have their therapeutic effect.

What you need to know when treating angina

• The patient already after 2-3 days notices a significant improvement in his condition.
• Do not think that the disease will go away in a few hours after taking antibiotics.
• If you adhere to the rules for taking medications, situations in which treatment does not help should not arise.
• Therapy will be ineffective if the doctor prescribes a medicine for the patient without finding out the nature of the pathogen and its resistance to certain drugs.
• Treatment will fail if diagnosed incorrectly.
• When staphylococcus aureus is the cause of sore throat, it is he who is the main causative agent of sore throat - penicillin antibiotics may not help, since this bacterium is resistant to them.

What can be done to determine the cause of therapy failure?

Features of the treatment of angina with antibiotics

The stability of pathogenic microflora is evidenced by two factors:

1. After antibiotic treatment, the disease does not go away.
2. The disease recedes, but very soon reappears.

Angina cannot be chronic, therefore it is quite clear that the primary exacerbation is completed, but against the background of weak immunity, a second disease appears very soon.

But most often the resistance of pathogenic microflora is manifested by the complete absence of the effect of taking antibiotics.

What is the reason for such immunity? Staphylococci are surrounded by metabolic products, which include enzymes that break down and deactivate penicillins.

Here is a list of antibiotics of the penicillin group, which they try not to prescribe for angina:

In the list, the drugs are arranged as their therapeutic effect increases, that is, the first ones do not help at all, and those below - depending on the situation.

Meanwhile, there are no cases of pathogen resistance during treatment with inhibitor-protected agents:

If therapy with these drugs does not work, then the patient is violating the regimen or the doctor has made the wrong diagnosis.

The reasons for the resistance of the pathogen to an antibiotic:

• The initial resistance of the strain of bacteria that infect the body.
• Improper use of the drug (instillation of systemic medicines in the nose or using them to rinse the throat).
• Prescribing drugs that have already shown their ineffectiveness in this patient.

The latter disruption of therapy, sometimes tolerated by doctors, is egregious and unjustifiable. In medical practice, there are cases when a doctor prescribes penicillin injections to a patient in the old fashioned way, although the outpatient card says that this patient has already been treated with penicillins, and they did not help him.

How to determine the presence of resistance?

What to do to determine addictive bacteria? First of all, this is revealed by the lack of positive dynamics in the patient's condition, and sometimes by its deterioration.

It is generally accepted that if significant changes in the patient's well-being are not observed during the first two days from the start of treatment, then the antibiotic should be replaced. However, the diagnosis may need to be rechecked.

The sodium salt of benzylpenicillin is a rather old antibiotic, which is ineffective in 25% of cases.

What should the patient do in this case? First of all, he must go to the doctor. If the doctor, instead of taking a swab from the throat to determine the sensitivity of microbes to an antibiotic, tells the patient to wait, you need to change the doctor.

After changing the medication and prescribing adequate treatment from the patient (regarding the drug intake regimen), discipline is required.

Error in diagnosis

In chronic tonsillitis, after antibiotic treatment, repeated exacerbations often occur in a month or two. In terms of symptoms, they are very similar to the manifestations and symptoms of angina, but an experienced doctor will always be able to distinguish one disease from another.

Relapses of chronic tonsillitis are usually faster and easier than tonsillitis. Therefore, such a patient with any antibiotic therapy feels relief relatively quickly.

Despite the fact that chronic tonsillitis is also treated with antibiotics, this disease additionally requires:

1. Strengthening the immune system.
2. Washing the lacunae of the tonsils.
3. Elimination of factors contributing to the exacerbation of the disease.

Why is it that even doctors sometimes make mistakes when diagnosing? There can be three reasons:

• Most often, this is the similarity of the symptoms of angina and chronic tonsillitis.
• The patient does not accurately tell the doctor the data of his anamnesis.
• The doctor simply does not want to understand the problem.

How to distinguish sore throat from tonsillitis

1. Usually, if, after antibiotic therapy, repeated angina occurs at short time intervals (a week, two, a month), there is no doubt that this is precisely chronic tonsillitis.
2. Another sign is the constant presence of yellow plugs on the patient's tonsils, which are often confused with festering follicles characteristic of follicular tonsillitis.
3. The tonsils themselves are constantly enlarged, which also indicates chronic pathology.
4. Almond plugs later turn into solid neoplasms.

If antibiotic therapy of chronic tonsillitis was prescribed by a doctor who confused the disease with angina, you should consult another doctor. Otherwise, the fight against the disease can take several years. In the end, the patient will need surgery to remove the tonsils, and such cases are not uncommon.

For those people who prefer self-medication to adequate medical care, an urgent advice: stop considering yourself a doctor and go to a good clinic! Otherwise, these patients not only run the risk of losing tonsils, but also acquire chronic kidney disease and severe heart defects.

The video in this article will tell you how to deal with angina.

The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

Do you know what, angina can give complications to vital organs? And the fact that it can even be fatal? It really is. Perhaps, after reading this article, you will be more serious about the sore throat that you get during the cold season.

What is angina?

Angina is an inflammatory process that occurs in the tonsils, popularly called "glands". Where your tonsils are located is probably not necessary to tell. The causative agent of this disease is streptococcus. Sore throats are mainly affected by young people and children. Streptococcus will already work in your tonsils, and you will know about it only after one or two days.

How is angina manifested?

This is a sore throat, you cannot even swallow liquid food. This causes you severe pain. The temperature is very high. Maybe even up to 40 degrees. You feel overwhelmed, all the signs of intoxication are present. Submandibular lymph nodes are enlarged. If a baby is sick, then, as a rule, he does not want to eat, sometimes they cannot even unclench their teeth.

Sore throats are lacunar, follicular, catarrhal and purulent-necrotic. With lacunar tonsillitis, the surface of the tonsils is inflamed, covered with a purulent bloom. This plaque can be removed fairly easily with a cotton swab. And if the tonsils are covered with white dots, then this is follicular tonsillitis. Catarrhal sore throat is manifested by inflammation of the tonsils, redness, but there are no abscesses and plaques on them. The last of the listed types - purulent-necrotizing tonsillitis - is a very serious, but at the same time, rare disease. With this type of angina, purulent lesions extend beyond the tonsils.

Why is angina so dangerous?

The fact is that after a sore throat, and sometimes even before its end, inflammation of the myocardium can develop, the work of the heart valves, damage to the renal tissue, and rheumatoid processes are disrupted.

That is why, in case of a sore throat, you need bed rest. This is to avoid complications.

What else is angina unpleasant?

It can become chronic. Here you seem to have completely recovered. A little time passes, and you fall ill again. What is happening to you? Maybe you tried to treat a sore throat on your own or did not treat it at all, you waited until it passed by itself. In this case, microbes simply lurk in the body, in the tissues of the tonsils. Now the right conditions appeared, and they again began their malicious activity. Maybe you got wet in the rain, or maybe you just had a fight with your boss. It's enough.

So many microbes have accumulated in the tonsils that they can get into the maxillary sinuses or into the ears. Then the inflammatory process develops in these organs.

Angina is contagious!

Do not forget about this, especially if there are babies in the family. Allocate a separate room for the patient, cutlery and hygiene products. When entering this room, put on a special mask. Streptococcus is transmitted by airborne droplets and can spread up to two meters. The closer you get to the source of the infection, the more dangerous it is for you. If you are in the same confined space with a sick person for a long time, if the air temperature is not very high, and the humidity is vice versa, then you have a chance of contracting streptococcus. In addition, you can "pick up an infection" even from food contaminated with an infection. There are types of foods on which streptococci live and reproduce wonderfully. These are dairy products, raw meat, vegetables, jams, jelly, mashed potatoes. Streptococci can get on food from the hands of a sick person.

Which is slightly inferior in frequency to flu and colds. No wonder the word translated from Latin means "squeeze, squeeze". In the acute form of pathology, the glands increase in size so that they close the entire throat, preventing breathing and swallowing. In this case, the patient experiences severe pain. Treatment of sore throat will be successful when using antibacterial agents. But it happens that even after antibiotics, angina does not go away. There are several reasons for this.

There are several pathogenic microorganisms leading to. In the first place are bacteria of streptococcal nature. You can fight them only with antibiotics. But not all drugs can completely destroy the pathogen. The bacteria are most resistant to antibiotics of the penicillin group: "Ampicillin", "Amoxicillin". But the new generation antibacterial agents - macrolides and cephalosporins - have a strong effect, and the pathogen's resistance to them rarely occurs.

Microorganisms become resistant to antibiotics when the infection is not diagnosed in adults. And they:

• use drugs that do not eliminate the symptoms of the disease;
• improperly use antibacterial medications;
• self-medicate, choosing drugs at their own discretion.

It is possible to determine the resistance of bacteria to a specific agent when there is no improvement after treatment within 2 days. In this case, the drug is replaced with a more effective drug.

The viral nature of inflammation of the glands, all the more, cannot be cured with antibiotics. Other means are needed here. Determine the presence of a viral infection by the common cold, which is a companion of ARVI. A whitish bloom on adjacent tissues is also attributed to signs of damage to the tonsils by a fungus. In this case, only antimycotics will help, and not antibacterial agents.

Initially misdiagnosed

Exacerbation of sore throat and after treatment occurs with poor diagnosis. Only taking anamnesis, relying on the patient's complaints and an external examination of the sore throat will not give a complete picture of the disease.

It is important for the doctor to determine the type of infectious agent, the form of the disease. Therefore, it is necessary to conduct a study of a smear taken from the surface of the inflamed tonsils.

If, after recent therapy, the throat hurts again, then this is most likely a chronic form of infection. In this case, the tonsils will be enlarged constantly. For a long time in the morning, the patient feels sore throat. On the hyperemic tonsils, yellowish plugs are found. In this case, another treatment is prescribed.

Chronic transition

A patient who has suffered an acute angina lacks persistent immunity to the disease. Re-infection is easy, especially when self-medicating. An untreated infection is worse, as it leads to the emergence of a permanent focus of infection. The bacteria remaining on the surface of the tonsils disrupt the tissue structure. And the absorption of allergens into the blood leads to the fact that the tonsils become a reservoir of pathogenic bacteria. Hence the constant relapses of tonsillitis, accompanied by:

• bad breath;
• tingling pain in the throat;
• rapid fatigue;
• constant headache;
• an increase in body temperature.

When the symptoms of inflammation of the tonsils do not go away for a long time, then it is necessary to choose such drugs that will be effective in the fight against chronic tonsillitis. These include antibacterial agents of the macrolide group.

Inappropriate use of antibiotics

Antibiotic treatment should take place not only until the signs of sore throat disappear. Usually, without completing the treatment, the patient falls ill again. But at the same time he gets complications that could have been avoided.

Antibacterial agents in the form of tablets are taken for 2 weeks, then the pathogen will be completely suppressed. And the patient will fully recover without relapse. When carrying out treatment at home, you must strictly follow the doctor's instructions, do not quit taking the medicine halfway.

Together with antibiotics, it is necessary to use topical agents for angina: sprays, solutions. They will wash away pathogenic bacteria in purulent or serous exudate from the surface of the tonsils.

The use of antibiotics is continuous, without interruption. Do not skip the time of taking antibacterial agents.

Re-infection with sore throat

Relapse of sore throat is rare and only with the wrong treatment. In rare cases, bacteria again enter the human body and cause inflammation of the tonsils. This happens because:

• the body is weakened after a sore throat;
• close environment is a source of infection;
• there was a sharp hypothermia of the body;
• throat irritation begins due to allergies, dust, smoking.

Recurrent angina is an exception to the rule, because a protective barrier remains in the tonsils, and antibodies that fight bacteria in the blood. The only complication after the flu can occur in the form of inflammation of the tonsils. Then you need to select antiviral drugs.

The main problem of the prolonged course of angina is that the requirements of therapy, based on the causative agent of the pathology, are not met. After a bacterial infection and taking antibiotics, the body's response can be mixed. The fungal type disease will replace the inflammation caused by bacteria. The symptoms will be similar, but the drugs must be different.

Often during therapy, the patient overdoes it with hot drinks, the throat becomes burned, and this leads to redness of the tonsils. And then the inflammatory process will begin again, because the damaged tissues of the tonsils will not be able to resist pathogenic microorganisms.

The disease also returns when the throat is irritated with chemical reagents, mechanical objects. Then symptoms of infection with increased body temperature, sore throat when swallowing join the tumor.

The emergence of another disease

Often, recurrent sore throat after antibiotic treatment of sore throat is mistaken for recurrent inflammation. But other infections often occur with symptoms similar to angina:

1. Tonsillitis is also caused by bacteria, but the disease affects not only the tonsils, but also the adjacent parts of the throat.
2. Pharyngitis is an infection that has got on the mucous membrane and lymphoid tissue of the pharynx. Inhalation of hot or polluted air will cause illness. Causes inflammation and chemicals, dust particles.
3. Laryngitis is a complication of respiratory diseases. With it, the mucous membrane of the larynx and vocal cords become inflamed. The viral nature of the infection is noted.
4. Infectious mononucleosis affects children from 3 to 9 years old. Symptoms of the disease lie in the damage to the lymphatic system, liver, spleen. Angina is one of the signs of pathology.

If you experience weakness, pain and redness in the throat, you should undergo a complete examination, and not self-medicate.

How to distinguish sore throat from tonsillitis

Tonsillitis is often confused with angina, but there are differences in the symptoms and course of the disease.

Angina is characterized by a rapid onset with a high body temperature, muscle aches. Tonsillitis proceeds more calmly. The same signs in pathologies are pain and sore throat, redness of the tonsils. But with tonsillitis, the walls of the throat also swell.

With angina, there are no signs such as nasal congestion, runny nose. Purulent plugs are rarely found on the surface of the tonsils with tonsillitis.

Most often, tonsillitis becomes a chronic form, and an acute form is more characteristic of angina.

In the treatment of both diseases, antibacterial agents are used, but acute inflammation of a purulent nature cannot be cured without antibiotics. And the course of tonsillitis can be stopped by other means.

More attention is paid to biostimulants and vitamins in the treatment of chronic tonsillitis. It is advisable to use therapeutic measures, physical procedures in treatment, while staying in sanatoriums and resorts. It is important to pay attention to general strengthening procedures.

What to do if sore throat does not go away after treatment

When the result of the treatment of angina is not visible, then it is necessary to contact a specialist for additional examination. Only a thorough study of biological material, bacterial culture can lead to the identification of the causative agent of the disease.

If the pathological condition is caused by a virus or fungus, then appropriate drugs and physiotherapy are also selected.

It is necessary to change the drug when the previous drug did not give a positive result when taken.

During the selection of therapeutic measures, not only the type of pathogen is taken into account, but also the patient's condition, his tolerance of certain drugs. Determine at what level the patient's protective system is.

Treatment is prescribed based on laboratory tests. If the signs of inflammation do not decrease after taking medications, then it is necessary to differentiate the disease from pathologies similar in symptoms.