Tonsillitis is a common disease of childhood and adolescence. The diagnosis of tonsillitis generally requires the consideration of Group A beta-hemolytic Streptococcus (GABHS) infection. However, numerous other bacteria alone or in combinations, viruses and other infections and non-infectious causes should be considered. Recognition of the cause and choice of appropriate therapy are of utmost importance in assuring rapid recovery and preventing complications.

Penicillin is currently the first-choice treatment for GABHS pharyngotonsillitis. However, the growing failure of penicillin to eradicate GABHS is of concern. This website discusses the potential causes of penicillin failure ( i.e. the presence of beta-lactamse producing bacteria that can “protect” GABHS from penicillins) and methods to overcome them. It also discusses the role of anaerobic bacteria in tonsillitis and its complications.


Thursday, January 21, 2016

Probiotic for the treatment of recurring group A beta-hemolytic streptococci pharyngo-tonsillitis

A recent retrospective study has shown that an oral preparation of Streptococcus salivarius K12 (SsK12) may be a good option for treating patients who have group A beta-hemolytic streptococci (GABHS), especially those patients who  require frequent antibiotic therapy. The study was completed by Giuseppe Gregori, MD and colleagues, of the Primary Care Department, in the Department of Health Science at the University of Genoa, Italy, and was published in Therapeutics and Clinical Risk Management on January 2016.

The study assess retrospectively if SsK12 use in pediatric patients with recurrent group A beta-hemolytic streptococcal (GABHS) tonsillitis (RPTI) reduce the occurrence of  GABHS relapses during the treatment period, and during the following 12 months as well as compared to a group of children with GABHS RPTIs not being treated with SsK12.

There were 130 children in this study, 76 were treated with SsK12, and 54 were the control group. The investigators found that the reduction of infections observed in the SsK12-treated children was statistically higher than the controls. Additionally, the children treated with SsK12 experienced significantly fewer GABHS infections both during the initial 90 days of inclusion in the study, when the treatment group received SsK12, and in the following 9 months.


The authors noted that even though treatment with SsK12 oral preparation made the need for antibiotic therapy against GABHS infections four times less likely, the retrospective, observational study has less validity than a double-blind, controlled, prospective, and randomized investigation. They recommended that further studies and additional investigations would be performed on this topic.



Group A beta hemolytic streptococcal tonsillitis