The Pharmaceutical Journal
Vol 269 No 7215 p353
14 September 2002

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Increase in Lemierre's cases could be due to decrease in antibiotic use

Cases of a rare but potentially fatal bacterial infection with symptoms similar to influenza could have risen as a result of the decrease in antibiotic prescribing, according to the Public Health Laboratory Service.

Speaking at the PHLS annual conference at Warwick University, Dr Jon Brazier, of the PHLS anaerobe reference unit in Cardiff, said that previously only about 20 cases of Lemierre's disease occurred annually in the United Kingdom. However, in 1999 this figure rose to 37 and, although incidence dropped back to normal in 2000, it rose again last year.

Dr Brazier said: "The key to tackling this infection is early treatment with anti-biotics, but the problem is that one of the initial symptoms is a sore throat. Most sore throats are viral in origin and, of course, doctors have been cautioned against the use of antibiotics for viral infections over recent years because antibiotics are ineffective against viruses, and using them in this way will only contribute to the growing problem of antibiotic resistance."

He added it was important for doctors to be aware of this unusual condition in order to be able to consider antibiotic treatment where they suspected it could be the cause of illness. Lemierre's disease can be distinguished from viral sore throats by the severity and duration of its symptoms and the presence of fever, rigors and tender, swollen lymph nodes. In addition, symptoms that often accompany viral infections, such as a runny nose and dry cough, are absent.