Bacterial pharyngotonsillitis and antimicrobial sensitivity in adults in a tertiary health facility in north west Nigeria

Abstract

Background: Pharyngotonsillitis is inflammation of the pharynx and tonsils, characterised by increased redness, exudate, ulceration, and membranes over it. The most common bacterial cause is Streptococcus pyogenes. Although the diagnosis is clinical, throat culture is the gold standard for confirmation. The aim was to determine the pattern of bacterial pharyngotonsillitis and antimicrobial sensitivities among adults at a tertiary health facility in North West Nigeria.

Materials and Methods: This was a hospital-based, descriptive, cross-sectional study of adults presenting to the outpatient clinic of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. The study period spanned January 2024 to July 2024. Interviewer-administered questionnaires were filled out by consenting adults, and throat swabs were taken for bacteriology and antimicrobial sensitivity.

Results: 120 adult patients. Most of them were female (95, 79.2%), and the rest were male (25, 20.8%), with a ratio of M: F 1:1.4. The majority of the participants reported odynophagia (100%), sore throat (114, 95%), and fever (60, 50%). About 83 (69.2%) of respondents were off antibiotics for the last four weeks, (42, 35.8%) had URTI, (39,32.5%) had lived with and had a primary relative with similar complaints.

The prevalence of bacterial pharyngotonsillitis in adults was 84.2%. Most isolated bacteria were Streptococcus Pyogenes, 54.5%, closely followed by Staphylococcus aureus 44.5%, Streptococcus Pyogenes was highly sensitive to Levofloxacin (70.9%), followed by Azithromycin (65.5%). Staphylococcus aureus was also sensitive to Levofloxacin (82.2%) and azithromycin (68.9%), and resistant to meropenem and some cephalosporins.

Conclusion: Group A β-haemolytic streptococci remain a major cause of bacterial pharyngotonsillitis. Levofloxacin and azithromycin demonstrated higher sensitivity against S. pyogenes and Staph. aureus, whereas meropenem and some cephalosporins exhibited resistance, which is worrisome. The emergence of antibiotic-resistant clinical isolates highlights the need for local sensitivity and empirical use of levofloxacin and azithromycin where facilities are absent.