Academic Journal
Pharyngitis in low-resources settings: a pragmatic clinical approach to reduce unnecessary antibiotic use
| العنوان: | Pharyngitis in low-resources settings: a pragmatic clinical approach to reduce unnecessary antibiotic use |
|---|---|
| المؤلفون: | Smeesters, Pierre, Campos, Dioclécio, Van Melderen, Laurence, de Aguiar, Eurico, Vanderpas, Jean-Baptiste, Vergison, Anne |
| المصدر: | Pediatrics, 118 (6 |
| سنة النشر: | 2006 |
| المجموعة: | DI-fusion : dépôt institutionnel de l'Université libre de Bruxelles (ULB) |
| مصطلحات موضوعية: | Sciences bio-médicales et agricoles, Anti-Bacterial Agents -- therapeutic use, Child, Preschool, Drug Utilization -- standards, Female, Humans, Infant, Male, Pharyngitis -- drug therapy, Pharyngitis -- microbiology, Poverty, Prospective Studies, Streptococcal Infections -- drug therapy, Antibiotic use, Developing countries, Pharyngitis, Practice guidelines |
| الوصف: | OBJECTIVE. Existing scoring systems for the diagnosis of group A streptococcus pharyngitis are insensitive or inapplicable in low-resources settings. Bacterial cultures and rapid tests can allow for antibiotic prescription abstention in high-income regions. These techniques are not feasible in many low-resources settings, and antibiotics often are prescribed for any pharyngitis episode. However, judicious antibiotics prescription in the community also is of concern in low-income countries. The objective of this study was to develop a clinical decision rule that allows for the reduction of empirical antibiotic therapy for children with pharyngitis in low-resources settings by identifying non-group A streptococcus pharyngitis. PATIENTS AND METHODS. We prospectively included children with pharyngitis in 3 public hospitals of Brazil during 9 months in 2004. We filled out clinical questionnaires and performed throat swabs. Bilateral χ2 (2-tailed test) and multivariate analysis were used to determine score categories. The outcome measures were sensitivity, specificity, positive likelihood ratio, and posttest probability of non-group A streptococcus infection with the clinical approach as compared with throat culture. RESULTS. A total of 163 of the 220 children had non-group A streptococcus pharyngitis (negative culture). We established a 3-questions decision rule (age and viral and bacterial signs) with 3 possible answers. The use of this score would prevent 41% to 55% of unnecessary antimicrobial prescriptions. The specificity of the score for non-group A streptococcus pharyngitis was >84%. CONCLUSION. Such a clinical decision rule could be helpful to reduce significantly unnecessary antibiotic prescriptions for pharyngitis in children in low-resources settings. Copyright © 2006 by the American Academy of Pediatrics. ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't ; SCOPUS: ar.j ; info:eu-repo/semantics/published |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | 1 full-text file(s): application/pdf |
| اللغة: | English |
| Relation: | uri/info:doi/10.1542/peds.2006-1025; uri/info:pii/118/6/e1607; uri/info:pmid/17142490; uri/info:scp/33947125031; local/VX-006107; https://dipot.ulb.ac.be/dspace/bitstream/2013/51695/4/73c6593f-d6f1-41e4-90a1-11fb5ffb4604.txt; http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/51695 |
| الاتاحة: | http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/51695 https://dipot.ulb.ac.be/dspace/bitstream/2013/51695/4/73c6593f-d6f1-41e4-90a1-11fb5ffb4604.txt |
| رقم الانضمام: | edsbas.17DB21B7 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |