antibioticsАнтибиотики и ХимиотерапияAntibiot Khimioter = Antibiotics and Chemotherapy0235-2990ООО «Издательство ОКИ»antibiotics-87Research ArticleЛЕКЦИИLECTURESА-стрептококковые инфекции глотки: диагностика и рациональная антибактериальная терапияGroup A Streptococcal Pharyngeal Infections: Diagnosis and Rational Antibacterial TherapyБеловБ. С.BelovB. S.noemail@neicon.ruНИИ ревматологии им. В. А. НасоновойРоссияV. A. Nasonova Research Institute of RheumatologyRussian Federation201806052020635-66875Copyright © ООО «Издательство ОКИ», 20202020ООО «Издательство ОКИ»ООО «Издательство ОКИ»https://www.antibiotics-chemotherapy.ru/jour/about/submissions#copyrightNoticehttps://www.antibiotics-chemotherapy.ru/jour/article/view/87

Проблема острого тонзиллита, вызванного бета-гемолитическим стрептококком группы А (БГСА), по-прежнему сохраняет свою актуальность как во врачебном, так и в общемедицинском плане. В настоящей статье представлены данные, свидетельствующие о возрождении высоковирулентной БГСА-инфекции и нарастании частоты осложнений (острая ревматическая лихорадка, синдром токсического шока), обоснована необходимость рациональной антибактериальной терапии данной патологии. Препаратами выбора для лечения острых форм БГСА-тонзиллита являются пенициллины и цефалоспорины I поколения, а при непереносимости бета-лактамных антибиотиков - макролиды. При наличии хронического рецидивирующего БГСА-тонзиллита, когда вероятность колонизации очага инфекции микроорганизмами, продуцирующими бета-лактамазы, достаточно высока, применяют ингибиторозащищённые пенициллины или цефалоспорины II-III поколения. Антибиотики - линкозамиды используют в терапии острого и хронического БГСА-тонзиллита как препараты резерва.

The problem of acute tonsillitis caused by Group A Beta-Hemolytic Streptococcus (GABHS) still remains relevant. This article provides data showing the revival of highly virulent GABHS infection and an increase in the incidence of complications (acute rheumatic fever, toxic shock syndrome), and substantiates the need for rational antibiotic therapy of this pathology. The drugs of choice for the treatment of acute forms of GABHS tonsillitis are penicillins and cephalosporins of the first generation, and macrolides in case of intolerance to beta-lactam antibiotics. In the presence of chronic relapsing GABHS tonsillitis, when the probability of colonization of the source of infection by microorganisms producing beta-lactamases is high enough, inhibitor-protected penicillins or cephalosporins of II-III generation are used. Lincosamide antibiotics are used in the treatment of acute and chronic GABHS tonsillitis as reserve drugs.

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The authors declare that there are no conflicts of interest present.