Bacteriological Study of Acute Follicular Tonsillitis


The objective of the study is to answer the following questions :-

1. Is there an actual failure rate in tonsillitis treatment with amoxicillin clavulanate ? If yes,

2. What is (are) the possible reason(s) to explain it in our locality ?

Full Title of Study: “Bacteriological Study of Acute Follicular Tonsillitis in Patients Attending the ENT Outpatient Clinic of Assiut University Hospital”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: April 2021

Detailed Description

Tonsillitis is one of the most common diseases in the throat that occurs in the younger age group .

The predominant bacteria causing tonsillitis are group A b-haemolytic streptococci (GABHS), which are highly susceptible to the penicillin group of antibiotics.

It has been reported in the literature that the rate of penicillin failure has consistently increased from about 7% in the 1950s to almost 40% in the 2000s.

Authors propose many reasons to explain such failure rates e.g. the coexistence of oropharyngeal beta-lactamase producing bacteria .

Although there were no documented reports, it was observed that there are rising reports of failure in treatment of acute follicular tonsillitis by amoxicillin clavulanate.


  • Drug: Amoxicillin Clavulanate
    • Intravenous drug intake of our drug.

Clinical Trial Outcome Measures

Primary Measures

  • The sensitivity of the isolated organism to amoxicillin clavulanate according to culture and sensitivity test
    • Time Frame: Baseline
    • throat swabs that will be taken from the tonsillar exudate, placed in sterile bottles and brought to the laboratory for Bacteriological culture of the organism and Antibiotic sensitivity tests will be done for the isolated organism(s).

Participating in This Clinical Trial

Inclusion Criteria

patients with acute follicular tonsillitis neither younger than five years nor older than 60 years old.

Exclusion Criteria

1. Other causes of tonsillitis that do not cause suppuration .

2. Age below five , and above 60 years .

3. Patients who received antibiotic one week before presentation .

4. Immune compromised patients .

5. Patients with quinsy.

Gender Eligibility: All

Minimum Age: 5 Years

Maximum Age: 60 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Assiut University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Mena Wahby Dous Hana, Principal investigator – Assiut University
  • Overall Contact(s)
    • Mena W Dous, Principal investigator, +201277170022,


Brook I. Overcoming penicillin failures in the treatment of Group A streptococcal pharyngo-tonsillitis. Int J Pediatr Otorhinolaryngol. 2007 Oct;71(10):1501-8. Epub 2007 Jul 17. Review.

Casey JR, Pichichero ME. The evidence base for cephalosporin superiority over penicillin in streptococcal pharyngitis. Diagn Microbiol Infect Dis. 2007 Mar;57(3 Suppl):39S-45S. Epub 2007 Feb 9. Review.

Sela S, Barzilai A. Why do we fail with penicillin in the treatment of group A streptococcus infections? Ann Med. 1999 Oct;31(5):303-7. Review.

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