Caractéristiques de l'automédication en ORL à l'Hôpital d'Instruction des Armées-Cotonou au Bénin / Characteristics of self-medication in ENT at Military Teaching Hospital Cotonou in Benin

Etudier l'ampleur et les caractéristiques de l'automédication en consultation ORL. Méthode: Etude descriptive du 1er juin 2020 au 1er février 2021 dans le service d'ORL-CCF/ Hôpital d'Instruction des Armées. Ont été inclus tous les patients reçus en consultation ORL ayant déclaré avoir utilisé des substances actives sans prescription médicale pour soulager leur plainte actuelle. 6 Résultats: L'automédication a été retrouvée chez 373 patients soit une prévalence de 47,88%. La moyenne d'âge était 32,26 ans (02 mois et 80 ans). Les sujets âgés 0 à 20 étaient plus représenté (68,4%). La sex-ratio était de 0,86. Les professions libérales étaient plus représentées (30%). La quasi-totalité des patients (98%) a pu énumérer au moins deux effets nocifs de l'automédication. Les médicaments en cause étaient les médicament en vente libre OTC (80%). Les principales raisons ayant motivé l'automédication ont été le coût élevé des prestations médicales (41,3%) et le manque de temps (33,2%). Conclusion: L'automédication a été retrouvée chez des patients volontiers jeunes, de sexe féminin, porteurs d'affections rhinologiques. Les OTC étaient en cause dans huit cas sur dix. Les principales motivations à l'automédication ont été le coût élevé des prestations médicales et le manque de temps

Prevalence and antibiotic susceptibility of group A beta-haemolytic streptococcal isolates in children presenting with acute pharyngitis in Lusaka, Zambia

Background. Group A beta-haemolytic streptococci (GABHS)-associated pharyngitis can complicate into rheumatic fever and rheumatic heart disease (RHD).Objectives. To determine the prevalence and antibiotic susceptibility of GABHS isolates in children presenting with acute pharyngitis and assess the utility of Zambian Treatment Guideline (ZTG) criteria as a local clinical scoring system.Methods. This descriptive cross-sectional study was conducted at the paediatric outpatient department of the University Teaching Hospital in Lusaka, Zambia. The study cohort, comprising children aged 3 - 15 years (n=146), were recruited as presenting with symptoms of pharyngitis. The children underwent a clinical assessment that included a detailed case history, presenting symptoms and a throat swab that was subsequently cultured. Microbial isolates were typed and the antibiotic sensitivity of cultured GABHS to penicillin and erythromycin determined.Results. GABHS were cultured from 22 (15.1%) children within this study. All the GABHS isolates (n=22) were susceptible to penicillin G; however, 19% of isolates displayed reduced susceptibility to erythromycin. None of the ZTG criteria, when used individually, was sufficiently sensitive to detect GABHS pharyngitis among this cohort.Conclusion. The prevalence of GABHS pharyngitis is similar that been described elsewhere. While GABHS remains highly susceptible to penicillin, which is used in the local RHD control programmes, concern remains for children treated with erythromycin owing to the resistance noted in some of the isolates. The ZTG clinical criteria displayed poor sensitivity in identifying GABHS pharyngitis. This has significant implications for effective diagnosis and treatment of pharyngitis and associated complications within this high RHD endemic area

The sore throat: a clinical approach to tonsillopharyngitis

Acute sore throat is a common complaint encountered by medical practitioners and health care workers routinely. The disease is mostly caused by viral infections of the upper respiratory tract and is usually self limiting. Symptoms rarely exceed two weeks, irrespective of the cause. Group A beta-haemolytic streptococci accounts for the majority of bacterial instances of tonsillopharyngitis. Clinical examination is not always adequate to diagnose bacterial infections, resulting in the irrational and over-prescribing of antibiotics, especially in upper respiratory tract infections, contributing to communal antimicrobial bacterial resistance. A few scoring systems are available to assist physicians in deciding on the aetiology without resorting to unnecessary laboratory investigations. This article briefly reviews the scoring systems and antimicrobial management of streptococcal throat infections

Comparing Performance of Amoxicillin and Intramuscular Benzathine Penicillin in Relieving Manifestations of Streptococcal Pharyngitis in Children

Objective: To compare clinical and bacteriologic responses to intramuscular benzathine penicillin G (BPG) and single dose of amoxicillin in Group A streptococcal (GAS) pharyngitis. Design: This study included 571 children from 6 to 15 years old age; with pharyngitis; who were admitted to 45 elementary and guidance schools from 7 regions of Education Organization in North-East of Iran; Mashhad. They were screened for enrollment and if he/she presented pharyngitis with clinical criteria of sore throat; erythema; exudate and tender or enlarged anterior cervical lymph nodes. Exclusion criteria included reports of antibiotic use; negative throat culture for GAS and history of allergy to the drugs. Clinical and bacteriologic responses to BPG and once daily orally amoxicillin were considered and compared. Results: In the amoxicillin group; treatment failure was more than the penicillin group (18.9 vs. 6.4; respectively) but the difference was not statistically significant (p 0.05). Both drugs were significantly effective in reducing pharyngitis manifestations but penicillin was significantly more effective in reducing exudate than amoxicillin. Conclusion: Our study was in line with studies comparing the two drugs. The results show that once-daily therapy with amoxicillin is as effective as intramuscular benzathine penicillin G for the treatment of GAS pharyngitis; but penicillin was significantly more effective in reducing exudate and concurrent signs vs. amoxicillin

Sprays and Lozenges for Sore Throats

A sore throat is a common complaint; and often an early indication of another medical condition; such as a cold. In the absence of life-threatening conditions or bacterial infection; local symptomatic treatment will ease the pain. This article reviews the common causes and symptoms of sore throats; and provides an overview of some of the sprays and lozenges that are available to treat this problem

Postoperative Throat Complications after Tracheal Intubation

Background:A prospective study was carried out to determine the incidence of sore throat after endotracheal intubation and the associated causative factors.Methods: Two hundred patients aged 18-77 years who had surgery over sixteen months were studied. Sizes 7mm - 8.0mm internal diameter (I.D) portex endotracheal tubes with cuff were used for females while sizes 8.5mm - 9.0mm I.D were used for males. A standardized form was used to collect patients' details; types of surgery; technique of airway maintenance and number of attempts at intubation. The use of nasogastric tubes; throat pack; duration of intubation and status of the anaesthetists were also noted. The presence of sore throat and other throat complications were determined within 24 - 36 hours after surgery.Results: One hundred twenty six (63) patients experienced throat complications. The incidence of sore throat was similar in both males and females. There was no statistically significant difference P=1.0000; odd ratio = 1.035; 95CI: 0.5064 - 2.115. There was no statistical difference between the group whose tubes were lubricated and the one without tube lubrication. P = 0.5296; odds ratio - 1.255; 95CI: 0.6702 - 2.351. There was statistically significant difference between the incidence of throat complications in throat related surgery and non- throat related surgery. P=0.0001.; odds ratio-9.771; 95CI: 3.065-31.148. Multiple attempts at intubation did not contribute to the development of sore throat. Duration of intubation greater than 60 minutes contributed to a higher incidence of throat complications and it was considered statistically significant.Conclusion:Routine endotracheal intubation can result in trauma and pathological changes; which could lead to postoperative throat symptoms. There is need to further evaluate if the use of smaller sized endotracheal tubes could reduce the incidence of throat complications

A community study of upper respiratory tract infection in Seychelles

The appropriate management of upper respiratory tract infections is a problem faced every day by community doctors in Seychelles. A workload survey has shown that it is the commonest reason for consulting these doctors with 12 per cent of their consultations accounted for by the spectrum of disease comprising pharyngitis; tonsillitis and rhinitis. Indeed; the problem is one of the commonest reasons for consulting primary health care workers worldwide