At the end of August, the Swedish Medicines Agency came up with new guidelines for the treatment of pharyngitis and tonsillitis, commonly called strep throat. The recommendations mean, among other things, that healthy adults and children from the age of six can be treated with penicillin for just five days. The new guidelines are based on local research by district doctor and PhD student David Thiel.
Strep throat is one of the most common reasons for antibiotics to be prescribed in health centres. When the Swedish Medicines Agency came up with the new guidelines, they essentially meant a shorter treatment period for many people with tonsillitis. Healthy adults and children from the age of six can now be treated with a more intensive course of four doses of penicillin for five days, compared with the previous course of three doses for ten days, for bacterial tonsillitis.
The advantage of the five-day course is that patients experience a faster return of symptoms with fewer and more short-term side effects. Additionally, the amount of antibiotics is reduced from 30 grams to 16 grams for the course of antibiotics, which is about half, says area physician and doctoral student David Thiel.
Shorter time to symptom-free
One of the studies that formed the basis for the new Swedish Medicines Agency guidelines on shorter treatment durations was conducted under David Thiel’s doctoral position, together with his supervisor Katarina Hedin, who is the research leader in Jönköping County and an associate professor in general medicine at Linköping University. The study was funded by the Public Health Agency and Futurum, Jönköping Region’s research and education activity. David Thiel is the lead author and carried out the analysis. He works weekdays at Bra liv Rosenhälsan Health Centre in Huskvarna, but will soon start working at Bra liv Näsjö Health Centre.
– The study showed that patients who were treated with a lower dose of penicillin four times a day for five days had a shorter time to resolution of symptoms regardless of whether three or four criteria for strep throat were met. This is what the Swedish Medicines Agency took into account: the treatment is just as good, the symptoms come back faster, and there are fewer and shorter side effects, says David Thiel.
Three or four criteria met
In the study baseline, patients who met three or four central criteria, which can be described as different signs of strep throat, participated. The four central criteria are fever over 38.5 degrees, swollen or painful lymph nodes in the corners of the jaw, absence of cough and deposits on the tonsils. If at least three of the criteria are met, antibiotic treatment is recommended.
Swedish Medicines Agency – Shorter treatment time for many people with tonsillitis
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