Italian Journal of Pediatrics (Nov 2024)
Treatment of acute pharyngitis in children: an Italian intersociety consensus (SIPPS-SIP-SITIP-FIMP-SIAIP-SIMRI-FIMMG)
- Elena Chiappini,
- Giovanni Simeone,
- Marcello Bergamini,
- Roberta Pellegrino,
- Alfredo Guarino,
- Annamaria Staiano,
- Susanna Esposito,
- Guido Castelli Gattinara,
- Andrea Lo Vecchio,
- Stefania Stefani,
- Iride Dello Iacono,
- Immacolata Scotese,
- Giovanna Tezza,
- Giulio Dinardo,
- Simona Riccio,
- Sofia Pellizzari,
- Sonia Iavarone,
- Giulia Lorenzetti,
- Elisabetta Venturini,
- Daniele Donà,
- Luca Pierantoni,
- Mattia Doria,
- Silvia Garazzino,
- Fabio Midulla,
- Claudio Cricelli,
- Luigi Terracciano,
- Annalisa Capuano,
- Eugenia Bruzzese,
- Daniele Ghiglioni,
- Lara Fusani,
- Eleonora Fusco,
- Paolo Biasci,
- Lamberto Reggiani,
- Luigi Matera,
- Enrica Mancino,
- Elisa Barbieri,
- Antonio D’Avino,
- Laura Cursi,
- Maria Giuseppa Sullo,
- Silvestro Scotti,
- Gian Luigi Marseglia,
- Giuseppe Di Mauro,
- Nicola Principi,
- Luisa Galli,
- Maria Carmen Verga
Affiliations
- Elena Chiappini
- Department of Health Sciences, University of Florence
- Giovanni Simeone
- Primary Care Pediatrician
- Marcello Bergamini
- Primary Care Pediatrician
- Roberta Pellegrino
- Department of Health Sciences, University of Florence
- Alfredo Guarino
- Department of Translational Medical Sciences, University of Naples Federico II
- Annamaria Staiano
- Department of Translational Medical Sciences, University of Naples Federico II
- Susanna Esposito
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma
- Guido Castelli Gattinara
- University Hospital Paediatric Department, Bambino Gesù Children’s Hospital, IRCCS
- Andrea Lo Vecchio
- Department of Translational Medical Sciences, University of Naples Federico II
- Stefania Stefani
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Section of Microbiology, University of Catania
- Iride Dello Iacono
- Pediatric Unit, Fatebenefratelli Hospital
- Immacolata Scotese
- Primary Care Pediatrician
- Giovanna Tezza
- Department of Pediatrics, Ospedale San Maurizio
- Giulio Dinardo
- Department of Woman, Child and of General and Specialized Surgery, University of Campania ’Luigi Vanvitelli’
- Simona Riccio
- Department of Woman, Child and of General and Specialized Surgery, University of Campania ’Luigi Vanvitelli’
- Sofia Pellizzari
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona
- Sonia Iavarone
- Onco-Hematology, Cell and Gene Therapy and Bone Marrow Transplant Clinic Area, Bambino Gesù Children’s Hospital, IRCCS
- Giulia Lorenzetti
- Department of Pediatrics, University of Rome Tor Vergata, Bambino Gesù Children’s Hospital, IRCCS
- Elisabetta Venturini
- Infectious Diseases Unit, Meyer Children’s Hospital IRCCS
- Daniele Donà
- Division of Paediatric Infectious Diseases, Department of Women’s and Children’s Health, University of Padua
- Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero Universitaria Di Bologna
- Mattia Doria
- Primary Care Pediatrician
- Silvia Garazzino
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children’s Hospital, University of Turin
- Fabio Midulla
- Department of Maternal Child and Urological Sciences, Sapienza University of Rome
- Claudio Cricelli
- Italian College of General Practitioners and Primary Care, (SIMG)
- Luigi Terracciano
- Pediatric Primary Care, National Pediatric Health Care System
- Annalisa Capuano
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli
- Eugenia Bruzzese
- Department of Translational Medical Sciences, University of Naples Federico II
- Daniele Ghiglioni
- Pediatric Primary Care, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, National Pediatric Health Care System
- Lara Fusani
- Department of Health Sciences, University of Florence
- Eleonora Fusco
- Department of Health Sciences, University of Florence
- Paolo Biasci
- FIMP (Federazione Italiana Medici Pediatri)
- Lamberto Reggiani
- Primary Care Pediatricians, Azienda Unità Sanitaria Locale (AUSL)
- Luigi Matera
- Department of Maternal Child and Urological Sciences, Sapienza University of Rome
- Enrica Mancino
- Department of Maternal Child and Urological Sciences, Sapienza University of Rome
- Elisa Barbieri
- Division of Paediatric Infectious Diseases, Department of Women’s and Children’s Health, University of Padua
- Antonio D’Avino
- Pediatric Primary Care, National Pediatric Health Care System
- Laura Cursi
- University Hospital Paediatric Department, Bambino Gesù Children’s Hospital, IRCCS
- Maria Giuseppa Sullo
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli
- Silvestro Scotti
- Pediatric Primary Care, National Pediatric Health Care System
- Gian Luigi Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia
- Giuseppe Di Mauro
- Pediatric Primary Care, National Pediatric Health Care System
- Nicola Principi
- Paediatric Department I, University of Milan
- Luisa Galli
- Department of Health Sciences, University of Florence
- Maria Carmen Verga
- Primary Care Pediatrician, Vietri sul Mare
- DOI
- https://doi.org/10.1186/s13052-024-01789-5
- Journal volume & issue
-
Vol. 50,
no. 1
pp. 1 – 11
Abstract
Abstract Sore throat represents one of the main causes of antibiotic overprescription in children. Its management is still a matter of debate, with countries considering streptococcal pharyngotonsillitis a benign and self-limiting condition and others advocating for its antibiotic treatment to prevent suppurative complications and acute rheumatic fever. Italian paediatricians frequently prescribe antibiotics on a clinical basis regardless of microbiological results. Moreover, broad-spectrum antibiotics are inappropriately prescribed for this condition. In this regard, an intersociety consensus conference was issued to promote the judicious use of antibiotic therapy in paediatric outpatient settings. A systematic review of the literature was performed, and updated recommendations were developed according to the GRADE methodology. Antibiotic treatment with amoxicillin (50 mg/kg/day) for 10 days is recommended in all children with proven streptococcal pharyngitis. Benzathine-penicillin could be prescribed in children with impaired intestinal absorption or inability to tolerate enteral intake and in those at high risk of suppurative complications with low compliance to oral therapy. In children with suspected amoxicillin allergy, third-generation cefalosporins for five days are recommended in low-risk patients, and macrolides are recommended in high-risk ones. Candidates for tonsillectomy due to recurrent pharyngitis could be treated with amoxicillin-clavulanic acid, clindamycin, or combined therapy with amoxicillin plus rifampicin for four days, in an attempt to avoid surgery.
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