URTI in Karachi: an appraisal of current isolated and antibiotic therapy

Recent reports in the literature indicate increasing involvement of Pneumnococci, HAEMOPHILUS INFLUENZAE and Klebsiella in community acquired throat infections. This was also our observation in a scrutiny of 576 throat swabs cultured during a 10 month period ending October, 1995. STREP. PYOGENES was isolated in only 6.6% of our cases, and remains 100% sensitive to the pencillins and cephalosporins. However, the possibility that its incidence is higher in deep tonsillar tissue is currently being investigated. Though Amoxycillin, Augmentin and Erythromycin have remained popular drugs for empirical treatment, increasingly, however, oral quinolones are being prescribed, which do not effectively cover pneumococci and are too broad in spectrum for common infected throats. H.INFLUENZAE, which is reported to colonize 25-75% of healthy human mucosa, can cause irritation ranging from uncomplicated pharyngitis to acute laryngoepiglottitis, and should be reported. It is currently resistant to several drugs including penicillin V, Doxycycline, Cotrimoxazole and Erythromycin [upto 97%] due to plasmid-mediated beta-lactamases and altered penicillin-binding proteins. While Klebsiella [15-20%] isolates are in different to several cephalosporins, it was sensitive to Augmentin, as were a majority of our pneumococcal and hemophilus cases. An audit is therefore presented encouraging the prescription of Augmentin, Amoxil and first generation Cephalosporins in uncomplicated URTI, with a macrolide such as Erythromycin, if LRTI symptoms are observed

unusual foreign body in an unusual abode

A case of unusual foreign body in Nose is discussed. The foreign body is unusual in respect of its history and difficulty in its location. As well as its failure to give a clue in routine X-ray