А-СТРЕПТОКОККОВЫЙ ТОНЗИЛЛИТ: СОВРЕМЕННЫЕ АСПЕКТЫ АНТИБАКТЕРИАЛЬНОЙ ТЕРАПИИ

The problem of acute tonsillitis caused by β-hemolytic group a streptococcus is still urgent both in the medical and general practical aspects. The present article highlights the data, which shows «the rebirth» of the highly virulent β-hemolytic group a streptococcal infection and growth of the complications frequency (acute rheumatic fever, toxic shock syndrome). The authors justify the necessity in rational antibacterial therapy against this pathology. The medications to treat acute forms of β-hemolytic group a streptococcal tonsillitis may be chosen among the following: penicillins (amoxicillin et al.) and I generation cephalosporins (cefadroxil), while in case of β-lactam antibiotic intolerance the choice may be shifted to macrolides (spiramycin et al.). In the event of chronic recurrent β-hemolytic group a streptococcal tonsillitis, when chances that bacteria, producing β-lactamases, will colonize the nidus of infection, are rather high, one should apply inhibitor protected penicillins (amoxicillin+clavulanic acid) or II generation cephalosporins (cefuroxime). lincosamins (lincomycin, clindamycin) are used in therapy against acute and chronic β-hemolytic group a strepto coccal tonsillitis as reserve medications. Key words: β- hemolytic group a streptococcus, acute tonsillitis, acute rheumatic fever, antibiotic therapy.