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Acute on chronic tonsillitis with streptococcal throat infection on penicillin.

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hi, myself amit kumar. 29 yrs male.i have a history of frequent sore throat right from my childhood. i have been treated with augmentin, penicilling etc.
3 yrs back i was tested for strep throat( pus:white spots were visible in tonsils). when blood test and urine test was done. Streptococcus infection was found. then doctors gave me cefuroxime axetil tabs. it was recurrent ebry 4 months . Augmentin and Cefuroxime dint work. Cephalexin was given then, again it recurred after 4 months and was treated with cephalexin. Later on Cephalexin stopped working. Then i was prescribed with Clindamycin 300(3times a day)for 10 days. and it worked. Now again after 5 months i have a severe strep throat with white patches all over and high fever. Please guide what should i have now. Clindamycin or something else


Category: ENT Specialist

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Category: ENT Specialist
Dr. Sunil Jalan is online now

Expert:  Dr. Sunil Jalan replied 4 Days.

Hello,

Thank you your query at DoctotrSping.

I can understand your problem, and will try to help you the best possible
You are suffering from Acute on chronic tonsillitis.

First of all your throat swab culture and sensitivity test (sample will be taken by touching a swab stick from your tonsil to find out causative bacteria and , they will check which antibiotic will work on it.) should be done, even it was done now it should be repeated.

Blood test just to check TC, DC. (total count , differential count), these counts increases in acute infection so it will conform acute infection is present

Treatment : (To be discussed with your Doctor and then initiate under his/ her guidance)

Augmentin (amoxicillin and clavulainc acid) is the 1st line drug, as it did not work last we can start 2nd line drug azithromycin (azee 500 mg once daily for 3 days).

We can add clindamycin so it will cover (it covers different group of bacteria, but as you have severe infection we should start this also.
With all this we should add medication which work for normal cold (antihistamines), analgesic, and medicine for acidity.

So your prescription will be-
Cap. Azithromycin (azee 500 mg once daily for 3 days).
Clindamycin 300(3times a day)for one week
Tab. Solvincold two times daily for 5 days
Tab. Zerodol two times daily for 5 days (analgesic)
Tab. Omez 20 mg two times daily 5 days

Summary of treatment:
• To consult an ENT specialist and do throat swab test
• To blood test (TC, DC)
• To start following medication – (To be discussed with your Doctor and then initiate under his/ her guidance)
Cap. Azithromycin (azee 500 mg once daily for 3 days).
Clindamycin 300(3times a day)for one week
Tab. Solvincold two times daily for 5 days
Tab. Zerodol two times daily for 5 days (analgesic)
Tab. Omez 20 mg two times daily 5 days

To follow you Throat swab result

Hope this helps. Feel free to ask if you have any further queries.

Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(CMC,VELLORE)DNB(ENT),DAA,MBA(HM)


Dr. Sunil Jalan
Category: ENT Specialist
Experience: 
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
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