La terapia antibiotica nelle patologie di pertinenza otorinolaringoiatrica

Although the present pharmacologic treatment has improved the course and the recovery of many ENT-diseases, recently an increase of new features and therapeutic perspectives occurred. The golden standard of the present antibiotic therapy is the eradication of the pathology, a rapid resolution of the symptomatology and of the infectiveness, combined with a great reduction and prevention of side effects and complications. An analysis of the ENT-diseases distribution in Italy, shows in the first place the infections of the middle ear (55%) followed by pharynx-tonsillar (30%) and sinusal infections (15%). This paper provides data about the antibiotic therapy in phlogistic pathologies of the ear, the rhino-sinusal district and in acute and chronic pharynx-tonsillitis, according to the most recent international guidelines. In the clinical practice, a first antibiotic therapy is rarely based on the identification of the responsible germ and on the antibiogram. At least at the beginning, therapy is planned on an empiric basis, therefore the use of large spectrum antibiotics is absolutely necessary: this choice involves criteria of thoughtful use, in order to avoid negative impacts both from a clinical point of view, due to the non-resolution of the problem and possible side effects, and from the economical point of view, due to the costs depending on the bad use of the drugs.