ABSTRACT
The often-indiscriminate use of antimicrobial agents has led to increased bacterial resistance over the past years. This phenomenon is not only evident in nosocomial environments but also at a community level. It is therefore important that, in addition to the rational use of antibiotics, an accurate prophylaxis is performed which includes the correct use of antimicrobials. Eighty children aged up to 10 years old, with a history of recurrent attacks of tonsillitis were included in this study. They were classified according to the frequency of occurrence of tonsillitis/year into the following groups: Group 1,40 children with a history of recurrent tonsillitis less than 4 attacks per year and group 2,40 children with a history of recurrent tonsillitis, 4 attacks or more per year. Blood samples were taken from each child for leukocytic count and measurement of erythrocytic sedimentation rate [ESR], antistreptolysin O titer [ASO], and C-reactive protein [CRP]. Throat swabs for microbiological examination were collected. Antibiotic sensitivity testing was done using antimicrobial discs of penicillin, cephradine, cefotaxime, ofloxacin, ciprofloxacin, ampicillin-sulbactam, gentamicin, ampicillin-cloxacillin 1:1, amoxicillin-clavulanic acid 2:1, cefuroxime and erythromycin. The isolates from group I were Streptococcus pyogenes [50%], Staphylococcus aureus [15%], Hemophilus infiuenzae [15%], Staphylococcus epidermidis [10%], Streptococcus agalactiae [5%] and Streptococcus pneumoniae [5%]. While the isolates from group 2 patients were Streptococcus pyogenes [15%], Staphylococcus aureus [20%], Neisseria and Streptococcus agalactiae [each 5%]. Mixed infection with Streptococcus pyogenes and Streptococcus pneumoniae constituted the majority of isolations among group 2 children [22 children, 55%]. This is in contrast to group I, where mixed infection was not reported at all. This difference was statistically significant. There was a significant difference between the 2 groups as regards the type of antibiotic used by each group where group I used all types of antibiotics. The use of antibiotic for the first time was also different where group 1 used more antibiotics than group 2