Del Mar C
Department of Social and Preventive Medicine, University of Queensland, Medical School, Herston.
Med J Aust. 1992 May 4;156(9):644-9.
To assess the justification for the use of antibiotics in the management of sore throat in general practice.
The literature from 1945 to 1990 was systematically screened to identify studies that addressed the question whether antibiotics reduce non-suppurative and suppurative complications and symptoms of sore throat. The key-words, "pharyngitis" and "tonsillitis" were used to identify trials of antibiotics for the treatment of sore throat.
Studies were included in comparison tables if they involved the trial of one or more antibiotics against a control and there was an outcome in terms of reduction in the incidence of acute rheumatic fever, acute glomerulonephritis, acute otitis media, acute sinusitis, quinsy or any symptoms related to the acute illness.
The published literature suggests that antibiotic treatment protects patients with sore throat against acute rheumatic fever and some suppurative complications, but not against acute glomerulonephritis. It does not reduce the symptoms.
In Australia, with the exception of socioeconomically deprived Aboriginal communities, the incidence of acute rheumatic fever is probably not high enough to justify the use of antibiotics for sore throat. Protection against suppurative infection seems to be slight and it is difficult to establish the benefit of antibiotic treatment for reducing the symptoms of sore throat. Until more benefits for antibiotic management of sore throat can be demonstrated, it is recommended that infrequent use be adopted.
评估在全科医疗中使用抗生素治疗咽喉痛的合理性。
系统检索了1945年至1990年的文献，以确定探讨抗生素是否能减少咽喉痛的非化脓性和化脓性并发症及症状的研究。使用关键词“咽炎”和“扁桃体炎”来识别抗生素治疗咽喉痛的试验。
如果研究涉及一种或多种抗生素与对照的试验，且有关于急性风湿热、急性肾小球肾炎、急性中耳炎、急性鼻窦炎、扁桃体周围脓肿或与急性疾病相关的任何症状发生率降低的结果，则纳入比较表。
已发表的文献表明，抗生素治疗可保护咽喉痛患者预防急性风湿热和一些化脓性并发症，但不能预防急性肾小球肾炎。它不能减轻症状。
在澳大利亚，除了社会经济贫困的原住民社区外，急性风湿热的发病率可能不足以证明使用抗生素治疗咽喉痛的合理性。预防化脓性感染的作用似乎不大，而且难以确定抗生素治疗对减轻咽喉痛症状的益处。在能够证明抗生素治疗咽喉痛有更多益处之前，建议不经常使用。
