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The Medical Clinics of North America Sep 2010Sore throat is a common medical complaint seen by the emergency practitioner, internist, pediatrician, and otolaryngologist. The differential for sore throat is vast.... (Review)
Review
Sore throat is a common medical complaint seen by the emergency practitioner, internist, pediatrician, and otolaryngologist. The differential for sore throat is vast. However, with a directed history this can often be narrowed down to 2 to 3 possible diagnoses. By paying particular attention to the associated symptoms and duration of symptoms, common self-limited etiologies like viral pharyngitis and nonstreptococcal tonsillitis can be distinguished from those that require more investigation, such as supraglottitis and tonsillar cancer. A sore throat is most commonly caused by an infectious, inflammatory, or neoplastic etiologic factor.
Topics: Epiglottitis; Gastroesophageal Reflux; Humans; Laryngeal Neoplasms; Pharyngeal Neoplasms; Pharyngitis; Referral and Consultation; Tomography, X-Ray Computed
PubMed: 20736104
DOI: 10.1016/j.mcna.2010.06.001 -
The Cochrane Database of Systematic... Jul 2015Antibiotics are sometimes used to prevent recurrent sore throat, despite concern about resistance. However, there is conflicting primary evidence regarding their... (Review)
Review
BACKGROUND
Antibiotics are sometimes used to prevent recurrent sore throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness.
OBJECTIVES
To assess the effects of antibiotics in patients with recurrent sore throat.
SEARCH METHODS
The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015.
SELECTION CRITERIA
Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent sore throat, defined as three or more sore throats in a year, examining the incidence of sore throat recurrence, with follow-up of at least 12 months post-antibiotic therapy.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response.
MAIN RESULTS
We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report.
AUTHORS' CONCLUSIONS
There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent sore throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent sore throat on the following outcomes: incidence of sore throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
Topics: Adult; Anti-Bacterial Agents; Child; Humans; Pharyngitis; Recurrence; Secondary Prevention
PubMed: 26171901
DOI: 10.1002/14651858.CD008911.pub2 -
Minerva Anestesiologica Sep 2020
Topics: Humans; Intubation, Intratracheal; Pharyngitis; Trachea
PubMed: 32441087
DOI: 10.23736/S0375-9393.20.14688-1 -
Anaesthesia Aug 2022
Topics: Humans; Intubation, Intratracheal; Laparoscopy; Pharyngitis; Postoperative Complications; Postoperative Period
PubMed: 35187659
DOI: 10.1111/anae.15695 -
Inflammation Research : Official... Oct 2012The aim of this review is to examine the causes, pathophysiology and experimental models of non-infectious pharyngitis (sore throat). (Review)
Review
OBJECTIVES
The aim of this review is to examine the causes, pathophysiology and experimental models of non-infectious pharyngitis (sore throat).
INTRODUCTION
The causes of sore throat can be infectious (viruses, bacteria, and fungi) or non-infectious, although the relative proportion of each is not well documented.
METHODS
A PubMed database search was performed for studies of non-infectious sore throat.
RESULTS AND CONCLUSIONS
Non-infectious causes of sore throat include: physico-chemical factors, such as smoking, snoring, shouting, tracheal intubation, medications, or concomitant illness; and environmental factors including indoor and outdoor air pollutants, temperature and humidity, and hazardous or occupational irritants. The pathophysiology underlying non-infectious sore throat is largely uncharacterised, although neurogenic inflammation looks to be a promising candidate. It is likely that there will be individual disposition factors or the coincidence of more than one irritant with possible--up to now unknown--interactions between them. Therefore, experimental models with defined conditions and objective endpoints are needed. A new model using cold dry air to directly induce pharyngeal irritation in humans, with pharyngeal lavage to measure biomarkers, may provide a useful tool for the study of mechanisms and treatment of non-infectious sore throat.
Topics: Air Pollutants; Animals; Disease Models, Animal; Environment; Humans; Pharyngitis; Smoking
PubMed: 22890476
DOI: 10.1007/s00011-012-0540-9 -
The Cochrane Database of Systematic... Jul 2015Sore throat is a common side-effect of general anaesthesia and is reported by between 30% and 70% of patients after tracheal intubation. The likelihood of a sore throat... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sore throat is a common side-effect of general anaesthesia and is reported by between 30% and 70% of patients after tracheal intubation. The likelihood of a sore throat varies with the type, diameter, and cuff pressure of the endotracheal tube used. If intubation is essential, it may be helpful to give drugs prophylactically to alleviate postoperative sore throat. Local anaesthetics and steroids have been used for this purpose. This review was originally published in 2009 and was updated in 2015.
OBJECTIVES
The objective of this review was to evaluate the efficacy and any harm caused by topical and systemic lidocaine used prophylactically to prevent postoperative sore throat in adults undergoing general anaesthesia with endotracheal intubation.
SEARCH METHODS
We searched CENTRAL (The Cochrane Library 2013, Issue 9), MEDLINE (January 1966 to October 2013), and EMBASE (1980 to October 2013). We also contacted manufacturers and researchers in the field. The original search was undertaken in June 2007. We reran the search in February 2015 and found four studies of interest. We will deal with those studies when we next update the review.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) of topical and systemic prophylactic lidocaine therapy versus control (using air or saline) that reported on the risk and severity of postoperative sore throat as an outcome.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information, such as the risk of any adverse effects.
MAIN RESULTS
We included 19 studies involving 1940 participants in this updated review. Of those 1940 participants, 952 received topical or systemic lidocaine therapy and 795 were allocated to the control groups. Topical and systemic lidocaine therapy appeared to reduce the risk of postoperative sore throat (16 studies, 1774 participants, risk ratio (RR) was 0.64 (95% confidence interval (CI) 0.48 to 0.85), the quality of the evidence was low), although when only high-quality trials were included (eight studies, 814 participants) the effect was no longer significant (RR 0.71, 95% CI 0.47 to 1.09). Lidocaine given systemically in two studies (320 participants) did not reveal evidence of an effect (RR 0.44, 95% CI 0.19 to 1.05 ). The severity of sore throat as measured on a visual-analogue scale (VAS) was reduced by lidocaine therapy (six trials, 611 participants, (mean difference (MD) -10.80, 95% CI -14.63 to -6.98). The adverse effects of lidocaine were not reported in these studies, though toxicity is generally rare.
AUTHORS' CONCLUSIONS
In our revised systematic review, although the results of included studies show generally positive results, they should be interpreted carefully. The effect size of lidocaine appeared to be affected by study quality; drug concentration; route of administration; management of cuff pressure during anaesthesia; the included population; and the type of outcome measured.
Topics: Anesthesia, General; Anesthetics, Local; Humans; Intubation, Intratracheal; Lidocaine; Pharyngitis; Postoperative Complications; Randomized Controlled Trials as Topic
PubMed: 26171894
DOI: 10.1002/14651858.CD004081.pub3 -
American Family Physician Mar 2004Sore throat is one of the most common reasons for visits to family physicians. While most patients with sore throat have an infectious cause (pharyngitis), fewer than 20... (Review)
Review
Sore throat is one of the most common reasons for visits to family physicians. While most patients with sore throat have an infectious cause (pharyngitis), fewer than 20 percent have a clear indication for antibiotic therapy (i.e., group A beta-hemolytic streptococcal infection). Useful, well-validated clinical decision rules are available to help family physicians care for patients who present with pharyngitis. Because of recent improvements in rapid streptococcal antigen tests, throat culture can be reserved for patients whose symptoms do not improve over time or who do not respond to antibiotics.
Topics: Algorithms; Diagnosis, Differential; Humans; Infectious Mononucleosis; Mucocutaneous Lymph Node Syndrome; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes
PubMed: 15053411
DOI: No ID Found -
Indian Journal of Pediatrics Oct 2011Sore throat is one of the common reasons for outpatient and emergency visits among children. It could be because of several etiologies; of these bacterial pharyngitis is... (Review)
Review
Sore throat is one of the common reasons for outpatient and emergency visits among children. It could be because of several etiologies; of these bacterial pharyngitis is the most important. Major challenge for the clinician is to diagnose group A beta hemolytic streptococcus (GABHS) pharyngitis and diphtheria, which are associated with serious complications. Throat swab smear with culture and rapid antigen tests are useful for making the diagnosis but the later may not be available in resource poor settings. Many clinical scores have been devised to diagnose GABHS with variable success but usually clinical features, epidemiological criteria and expert clinical judgment with or without supportive investigations indicate need for antibiotics. A child with sore throat and toxic look may have diphtheria or parapharyngeal/retropharyngeal abscess, and therefore should be hospitalized.
Topics: Anti-Bacterial Agents; Child; Humans; Medical History Taking; Pharyngitis; Pharynx; Physical Examination; Specimen Handling
PubMed: 21660400
DOI: 10.1007/s12098-011-0467-0 -
EBioMedicine Dec 2023Antibiotic consumption can lead to antimicrobial resistance and microbiome imbalance. We sought to estimate global antibiotic consumption for sore throat, and the...
BACKGROUND
Antibiotic consumption can lead to antimicrobial resistance and microbiome imbalance. We sought to estimate global antibiotic consumption for sore throat, and the potential reduction in consumption due to effective vaccination against group A Streptococcus (Strep A).
METHODS
We reviewed and analysed articles published between January 2000 and February 2022, identified though Clarivate Analytics' Web of Science search platform, with reference to antibiotic prescribing or consumption, sore throat, pharyngitis, or tonsillitis. We then used those analyses, combined with assumptions for the effectiveness, duration of protection, and coverage of a vaccine, to calculate the estimated reduction in antibiotic prescribing due to the introduction of Strep A vaccines.
FINDINGS
We identified 101 studies covering 38 countries. The mean prescribing rate for sore throat was approximately 5 courses per 100 population per year, accounting for approximately 5% of all antibiotic consumption. Based on 2020 population estimates for countries with empiric prescribing rates, antibiotic consumption for sore throat was estimated to exceed 37 million courses annually, of which half could be attributable to treatment for Strep A. A vaccine that reduces rates of Strep A infection by 80%, with 80% coverage and 10 year's duration of protection, could avert 2.8 million courses of antibiotics prescribed for sore throat treatment among 5-14 year-olds in countries with observed prescribing rates, increasing to an estimated 7.5 million averted if an effective vaccination program also reduced precautionary prescribing.
INTERPRETATION
A vaccine that prevents Strep A throat infections in children may reduce antibiotic prescribing for sore throat by 32-87% depending on changes to prescribing and consumption behaviours.
FUNDING
The Wellcome Trust, grant agreement number 215490/Z/19/Z.
Topics: Child; Humans; Anti-Bacterial Agents; Pharyngitis; Streptococcus pyogenes; Streptococcal Infections; Vaccines
PubMed: 37950997
DOI: 10.1016/j.ebiom.2023.104864 -
The Medical Clinics of North America Jan 1999Diseases of the adenoids and tonsils are a frequent cause for patients to seek medical attention. A thorough understanding of the disease processes reflected in the... (Review)
Review
Diseases of the adenoids and tonsils are a frequent cause for patients to seek medical attention. A thorough understanding of the disease processes reflected in the adenoids and tonsils and their diagnosis and treatment is an important part of routine care delivery. Diagnostic methodologies and timing of surgical intervention are reviewed along with general considerations relating to the differential diagnosis in adult and pediatric patients.
Topics: Abscess; Adenoidectomy; Adenoids; Adult; Child; Diagnosis, Differential; Humans; Hypertrophy; Pharyngitis; Tonsillectomy; Tonsillitis
PubMed: 9927961
DOI: 10.1016/s0025-7125(05)70088-2