Health & Fit: Practical health: bacterial or viral angina? Response in

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pharmacy, angina is an inflammation of the tonsils most often due to a virus (viral angina) and more rarely to a bacterial (bacterial angina). To make the distinction well, and thus limit the…

  Santé pratique : Angine bactérienne ou virale ? Réponse en pharmacie © Istock/Tommaso79

sore throat, swelling of the lymph nodes of the neck, difficulties in swallowing, fever, runny nose, cough, wrapping ... angina is one The most common ailments of winter. It is indeed a frequent disease since each year in France, around nine million angina is diagnosed according to the estimates of health insurance. This disease is distinguished by the fact that there are two types of angina: viral, the most common, due to a virus and bacterial angina due to the beta-hemolytic streptococcus of group A, which represents 25 to 40 % of cases in children and only, 10 to 25 % in adults thus, more than 80 % of angina are in viral origin and therefore have no need for antibiotics, knowing that making the distinction between the 'Viral angina and bacterial angina is important because their treatment is very different. Only bacterial angins require antibiotic treatment (cefuroxime, cefpodoxime, azithromycin, clarithromycin, josamycin), since the bacteria can cause complications which are very rare but possibly serious.

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, which is why the first reflex consists in carrying out a rapid diagnostic orientation test (TROD) angina. The Trod Angina is a sample of the throat made by a doctor or pharmacist which makes it possible to check the viral or bacterial origin of angina in a few minutes. As underlines the Ministry of Health on this subject, "TROD Angina therefore allow to take antibiotics only when necessary and to preserve their effectiveness by avoiding bacterial resistance to antibiotics. »The Angina quick test is done at the doctor (during consultation) or in pharmacy since the beginning of 2020 (the test costs around 6 to 7 euros and is reimbursed at 70% by health insurance) And this in the absence of prior medical consultation, in children aged 10 and over, and in adults. Concretely, it is a question of taking a sample at the level of the tonsils with a swab (large cotton swab), placed in a tube which contains a reagent. A strip is immersed in this liquid and changes color depending on the result in a few minutes.

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An important gesture to limit antibiotic resistance

If the latter is positive, angina is due to the bacteria Streptococcus in group A and that antibiotic treatment is necessary. Note that since December 13, 2021, in the event of a suspicion of angina to group A streptococcus, the doctor has the possibility of making the prescription the mention "if trod angina, within x calendar days". What does this mention mean? This allows the pharmacist to deliver the antibiotic only if the result of the angina carried out in pharmacy is positive, within 7 days maximum. Angina quick tests therefore allow antibiotics to be taken only when necessary and to preserve their effectiveness by avoiding bacterial resistance to antibiotics, also called "antibiotic resistance". Indeed, The France Assos Health association explains "that in the event of viral angina, antibiotics are ineffective. Prescribing it then unnecessarily makes the bed of antibiotic resistance, that is to say the increase in bacteria which are increasingly resistant in antibiotics and which seriously endangers the effectiveness of these drugs in the years to come .

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As a reminder, these tests were authorized in pharmacies called "pharmacy" by the Interministerial Committee for Health in March 2019, to complement those produced by doctors. The measure was implemented on February 1, 2020 to be finally suspended temporarily on March 23, 2020 because of the COVVI-19 epidemic. Their use is now possible in pharmacies again since July 1, 2021. Note that the angina is benign and heal alone in the vast majority of cases: the fever usually lasts 2 to 3 days, the sore throat up to 1 week. But if it lasts more than 3 days or resumes, if the sore throat worsens, in the event of the appearance of pimples on the skin, joint pain, respiratory discomfort, swelling of the neck or face, or all Another worrying sign, a consultation with the doctor is essential. It is also necessary to not take medication, even without a prescription, in particular anti-inflammatory drugs such as ibuprofen, without asking for advice from your doctor or pharmacist.

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