scholarly journals Analysis of awareness of practical medicinal doctors on diagnosis and treatment of pharyngitis in children

2021 ◽  
pp. 20-35
Author(s):  
O.R. Boyarchuk ◽  
◽  
O.M. Mochulska ◽  
Keyword(s):  
Primary Care ◽  
Antibiotic Therapy ◽  
Sore Throat ◽  
Throat Swab ◽  
Tertiary Care ◽  
Streptococcal Pharyngitis ◽  
Hemolytic Streptococcus ◽  
Diagnosis And Management ◽  
Group A ◽  
Primary Care Pediatricians

Painful throat is the main symptom of pharyngitis and one of the most common reasons to refer to a primary care physician. In 60.0–70.0% of cases acute pharyngitis is caused by viruses, including rhinoviruses, adenoviruses, enteroviruses, coronaviruses and others. More then about 5.0–15.0% of pharyngitis cases in adults and around 20.0–30.0% of cases in children are caused by bacterial infections, among which group A β hemolytic Streptococcus. Among other causative agents of bacterial pharyngitis, group C and group G Streptococcus, Mycoplasma pneumoniae, Chlamydia pneumoniae and Arcanobacterium haemolyticus are also reported, although much less frequently. Severe group A β-hemolytic Streptococcus-related diseases, such as acute rheumatic fever, rheumatic heart disease, post-streptococcal glomerulonephritis, and invasive infections are accountable for more than 517 000 deaths each year. Therefore, the issue of timely diagnosis and proper management of streptococcal pharyngitis is very important. Purpose — to study, evaluate and analyze the knowledge of pediatricians in diagnosis and management of sore throat in children and to identify further ways to raise their awareness. Matherials and methods. The poll among pediatricians on evaluation of diagnosis and management of pharyngitis in children were conducted. The study involved pediatricians of Ternopil region, Ukraine. In general 112 pediatricians were questioned. Among the participants 79 (70.5%) were the primary care pediatricians and 33 (29.5%) worked as the secondary and tertiary care pediatricians. Questionnaire and statistical research methods were used. Results. Overall, 70.5% of pediatricians prescribed a throat swab for patients with pharyngitis in selected cases. However, they rarely (20.0%) used Centor or McIsaak criteria to choose management strategy of sore throat. Amoxicillin as a first-line antibiotic for streptococcal pharyngitis was chosen by 66.1% of respondents and primary care pediatricians prescribed it more often than the secondary and tertiary care pediatricians (p=0.0006), but antibiotic therapy was prescribed for 10 days only by 52.7% of respondents. Less than half of the correct answers were to questions related to the prescribing of antibacterial therapy in healthy children, in which group A β-hemolytic Streptococcus is detected in throat swab (39.3%) and in cases of positive antistreptolysin-O (25.9%). Conclusions. The research showed a wide range of knowledge of pediatricians about the diagnosis and management of group A β-hemolytic Streptococcus pharyngitis — from satisfactory responses to the prescription of antibiotic therapy to low knowledge about the diagnosis and determination of strategies in healthy carriers. These data emphasize the need to improve knowledge about the strategies of group group A β-hemolytic Streptococcus pharingytis control. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: group A β-hemolytic Streptococcus, pharyngitis, diagnosis, treatment.

Variability in the Diagnosis and Treatment of Group A Streptococcal Pharyngitis by Primary Care Pediatricians

2014 ◽  
Vol 35 (S3) ◽  
pp. S79-S85 ◽  
Author(s):  
Julie L. Fierro ◽  
Priya A. Prasad ◽  
A. Russell Localio ◽  
Robert W. Grundmeier ◽  
Richard C. Wasserman ◽  
...  
Keyword(s):  
Primary Care ◽  
Streptococcal Pharyngitis ◽  
Diagnosis And Treatment ◽  
Group A ◽  
Primary Care Pediatricians

scholarly journals The feasibility of measuring calprotectin from a throat swab as a marker of infections caused by group A streptococcus: a case–control feasibility study

BJGP Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. bjgpopen20X101006
Author(s):  
Behnaz Schofield ◽  
Clive Gregory ◽  
Micaela Gal ◽  
David Gillespie ◽  
Gurudutt Naik ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthy Volunteers ◽  
Sore Throat ◽  
Throat Swab ◽  
Group A Streptococcus ◽  
Case Control ◽  
Antibiotic Prescribing ◽  
Group A ◽  
Primary Care Patients ◽  
Streptococcus A

BackgroundMost people with sore throat do not benefit from antibiotic treatment, but nearly three-quarters of those presenting in primary care are prescribed antibiotics. A test that is predictive of bacterial infection could help guide antibiotic prescribing. Calprotectin is a biomarker of neutrophilic inflammation, and may be a useful marker of bacterial throat infections.AimTo assess the feasibility of measuring calprotectin from throat swabs, and assess whether individuals with sore throats likely to be caused by streptococcal infections have apparently higher throat calprotectin levels than other individuals with sore throat and healthy volunteers.Design & settingA proof of concept case–control study was undertaken, which compared primary care patients with sore throats and healthy volunteers.MethodBaseline characteristics and throat swabs were collected from 30 primary care patients with suspected streptococcal sore throat, and throat swabs were taken from 10 volunteers without sore throat. Calprotectin level determination and rapid antigen streptococcal testing were conducted on the throat swab eluents. Calprotectin levels in the following groups were compared: volunteers without a sore throat; all patients with a sore throat; patients with a sore throat testing either negative or positive for streptococcal antigen; and those with lower and higher scores on clinical prediction rules for streptococcal sore throat.ResultsCalprotectin was detected in all throat swab samples. Mean calprotectin levels were numerically higher in patients with sore throat compared with healthy volunteers, and sore throat patients who had group A streptococci antigen detected compared with those who did not.ConclusionCalprotectin can be measured from throat swab samples and levels are consistent with the hypothesis that streptococcal infection leads to higher throat calprotectin levels. This hypothesis will be tested in a larger study.

scholarly journals Group A streptococcal pharyngitis: A practical guide to diagnosis and treatment

2021 ◽  
Vol 26 (5) ◽  
pp. 319-319
Author(s):  
Laura Sauve ◽  
A Michael Forrester ◽  
Karina A Top
Keyword(s):  
Primary Care ◽  
Acute Rheumatic Fever ◽  
Throat Swab ◽  
Group A Streptococcus ◽  
Streptococcal Pharyngitis ◽  
Clinical Syndrome ◽  
Indigenous Populations ◽  
Diagnosis And Treatment ◽  
Group A ◽  
Disproportionate Burden

Abstract Group A Streptococcus (GAS) pharyngitis is a common clinical syndrome in primary care, yet controversy remains regarding the best approach to diagnosis and treatment, including the benefits of antibiotics. Children who are likely to have GAS pharyngitis based on history or physical examination should have a throat swab and, when positive, be treated with amoxicillin or penicillin. The disproportionate burden of acute rheumatic fever in Indigenous populations in Canada and special considerations for testing and treatment are discussed.

Antibiotic Susceptibility Evaluation of Bacterial Agents Causing Infection in Children with Acute Tonsillopharyngitis

2020 ◽  
Vol 20 ◽  
Author(s):  
Hamidreza Sherkatolabbasieh ◽  
Majid Firouzi ◽  
Shiva Shafizadeh ◽  
Iman Amiri
Keyword(s):  
Sore Throat ◽  
Predictive Value ◽  
Positive Culture ◽  
Clinical Score ◽  
Streptococcal Pharyngitis ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Clinical Sensitivity ◽  
Group A

Background: The aim of this study is to evaluate the prevalence of group A beta-hemolytic pharyngitis by assessing the outcome of the culture and the resistance and sensitivity of group A beta hemolytic streptococcus to antibiotics. Methods: This cross-sectional study was conducted on 170 patients, aged 3-15 years, referred to the clinic with complaints of sore throat. Patients’ history was collected and physical examination was performed and were score based on clinical findings. Patients with other underlying pathologies and those taking antibiotics prior to the study were excluded from our study. Antimicrobial susceptibility test was performed by disk diffusion method against cephalexin, cefazolin, erythromycin and amoxicillin. Results: A total of 170 patients were reported with sore throat. Patients with positive culture results were 60% male and 40% female. Amoxicillin resistance was the greatest (5%) in the culture. All isolated bacteria were sensitive to amoxicillin, cephalexin, cefazolin and erythromycin. Patients with McIssac score ≥ 6 showed clinical sensitivity 75% specificity 61% negative predictive value 94.8% and positive predictive value 20.3% for Group A beta-hemolytic streptococcal pharyngitis. Conclusion: The results showed the higher the clinical score, the greater the chance of positive throat culture.

scholarly journals Streptococcal pharyngitis in general practice. 1. Some unusual features of the epidemiology

1992 ◽  
Vol 109 (2) ◽  
pp. 181-189 ◽  
Author(s):  
P. M. Higgins
Keyword(s):  
Sore Throat ◽  
Age Distribution ◽  
Positive Culture ◽  
Streptococcal Pharyngitis ◽  
Group A Streptococci ◽  
Upper Respiratory Tract ◽  
Acute Infections ◽  
Group A ◽  
Upper Respiratory ◽  
Highly Correlated

SUMMARYThis report is based on a study of acute infections of the upper respiratory tract in 1965 and detailed records of such infections in 1963 and 1964. A change from illnesses mainly yielding viruses to illnesses mainly yielding group A streptococci was noted around the age of 5 years. A positive culture for group A streptococci in patients over 4 years of age was highly correlated with a complaint of sore throat and with serological evidence of streptococcal infection. A bimodal age distribution curve for pharyngitis associated with a positive culture for group A streptococci was consistently noted. The incidence was highest in children aged 5–9 but a second smaller peak occurred among adults in the 30–39 age group. The evidence suggests that being female increases the risk of acquiring group A streptococci and of experiencing sore throat.

scholarly journals Sore Throat and Methicllin Resistant Staphylococcus Aureus Positive Pharyngo-Tonsillitis in a Tertiary Hospital

KYAMC Journal ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 177-181
Author(s):  
Md Abdus Salam ◽  
Md Mahabub Alom ◽  
Md Sultan Mahmud
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Sore Throat ◽  
Pathogenic Bacteria ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Throat Swab ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Care Hospital ◽  
Methicillin Resistant

Background: Antimicrobial resistance in health care-associated pathogens is a growing concern for healthcare and for public health. In response to these concerns, medical experts, professional societies and agencies, such as the Centers for Disease Control and Prevention (CDCP), have proposed initiatives to curtail the spread of antimicrobial resistance in pathogenic bacteria. Objectives: The purpose of the study was to observe the disease pattern and demographic characteristics of patient attending at the outpatient department of Otolaryngology in a tertiary care hospital suffering from sore throat and methicillin resistant Staphylococcus Aureus (MRSA) positive pharyngo-tonsillitis. Materials and Methods: This is a retrospective study carried out at the outpatient department of Otolaryngology in Khwaja Yunus Ali Medical College and Hospital for the period of January, 2016 to December, 2017. Data were collected based on history, clinical examinations and culture and sensitivity report of throat swab of the patients. Result: A total of 339 patients were studied of which 49.56% were male and 50.44% were female. The mean age was 30 years; maximum patient (36.28%) belongs to 21-30 years of age. Maximum patient (76%) were come from out of Sirajganj district specially North Bengal. Regarding result of throat swab of C/S 58.11% patients were MRSA positive, 26.84% patients were MRSA negative and15.04% patients has no growth. Conclusion: It is illogical to treat all sore throats with antibiotics. A large scale multi-center study should be performed in the country. A uniform data system should be constructed for Chronic Pharyngo-tonsillitis caused by Methicillin resistant Staphylococcus aureus in Bangladesh. KYAMC Journal Vol. 9, No.-4, January 2019, Page 177-181

scholarly journals Use of the McIsaac Score to Predict Group A Streptococcal Pharyngitis in Outpatient Nurse Phone Triage and Electronic Visits Compared With In-Person Visits: Retrospective Observational Study (Preprint)

2020 ◽  
Author(s):  
Jennifer L Pecina ◽  
Leah M Nigon ◽  
Kristine S Penza ◽  
Martha A Murray ◽  
Beckie J Kronebusch ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Observational Study ◽  
Sore Throat ◽  
Scoring System ◽  
Group A Streptococcus ◽  
Streptococcal Pharyngitis ◽  
Future Studies ◽  
Face To Face ◽  
Geographic Barriers ◽  
Group A

BACKGROUND The McIsaac criteria are a validated scoring system used to determine the likelihood of an acute sore throat being caused by group A streptococcus (GAS) to stratify patients who need strep testing. OBJECTIVE We aim to compare McIsaac criteria obtained during face-to-face (f2f) and non-f2f encounters. METHODS This retrospective study compared the percentage of positive GAS tests by McIsaac score for scores calculated during nurse protocol phone encounters, e-visits (electronic visits), and in person f2f clinic visits. RESULTS There was no difference in percentages of positive strep tests between encounter types for any of the McIsaac scores. There were significantly more phone and e-visit encounters with any missing score components compared with f2f visits. For individual score components, there were significantly fewer e-visits missing fever and cough information compared with phone encounters and f2f encounters. F2f encounters were significantly less likely to be missing descriptions of tonsils and lymphadenopathy compared with phone and e-visit encounters. McIsaac scores of 4 had positive GAS rates of 55% to 68% across encounter types. There were 4 encounters not missing any score components with a McIsaac score of 0. None of these 4 encounters had a positive GAS test. CONCLUSIONS McIsaac scores of 4 collected during non-f2f care could be used to consider empiric treatment for GAS without testing if significant barriers to testing exist such as the COVID-19 pandemic or geographic barriers. Future studies should evaluate further whether non-f2f encounters with McIsaac scores of 0 can be safely excluded from GAS testing.

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