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Penetration of penicillin V to tonsillar surface fluid in healthy individuals and in patients with acute tonsillitis

Published online by Cambridge University Press:  29 June 2007

A. Stjernquist-Desatnik ,
P. Samuelsson  and
M. Walder
A. Stjernquist-Desatnik*
Affiliation:
Department of Oto-Rhino-laryngology, University Hospital, Lund, Sweden
P. Samuelsson
Affiliation:
Department of Oto-Rhino-laryngology, University Hospital, Lund, Sweden
M. Walder
Affiliation:
Department of Medical Microbiology, Malmö General Hospital, Malmö, Sweden.
*
Anna Stjernquist-Desatnik, M.D., Ph.D., Department of Oto-Rhino-Laryngology, University Hospital, S-221 85 Lund, Sweden
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Abstract

In the treatment of group A streptococcal tonsillitis, as the bacteria are located on the epithelial surface, an important determinant of outcome is the concentration of penicillin in extracellular tonsillar surface fluid. Accordingly, we investigated the concentration of penicillin in serum, and penetration to tonsillar surface fluid and saliva in nine patients with acute group A streptococcal tonsillitis and in nine healthy controls.

Among the healthy subjects, despite high serum penicillin concentrations (mean, 2.04) (ig/ml), there was no penetration to tonsillar surface fluid or to saliva, whereas erythromycin penetrated to tonsillar surface fluid in 3/6 cases.

Of the nine patients with acute tonsillitis, on the first day of treatment eight manifested high concentrations of penicillin in tonsillar surface fluid (mean, 0.34 (ig/ml—i.e. well above the minimal inhibitory concentration (MIC) for group A streptococci), but penetration to saliva was found in only two patients. On the tenth day of treatment, penicillin was not present in the saliva of any of the patients and was present in the tonsillar surface fluid of only one. The results suggest that measurable concentrations of penicillin in tonsillar surface fluid can only be obtained in the presence of inflammation with fluid exudation through the tonsillar epithelium.

Keywords

TonsillitisPenicillin, concentrationStreptococcus
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 4 , April 1993 , pp. 309 - 312
Copyright
Copyright © JLO (1984) Limited 1993

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