Clinical predictors of childhood streptococcal pharyngitis

Abstract

Background Antibiotic prescription for the management of all acute pharyngitis seems to be increasing recently. Streptococcal pharyngitis is the one that has strong indication for antibiotic prescription. It is quiet hard to distinguish the clinical features of streptococcal pharyngitis from non-streptococcal one. Objective To determine specifically clinical features of streptococcal pharyngitis and distinguish them from non-streptococcal one. Methods We conducted a cross-sectional study on children with acute pharyngitis at Pediatric Outpatient Department Dr. M. Djamil Hospital, Padang from November 2006 until March 2007. Data on clinical features and pharyngeal swab culture results were analyzed using chi-square test for clinical predictors. All were then reanalyzed using multivariate logistic regression. Results Ninety-five children aged 3-13 years were enrolled and pharyngeal swab culture was performed. Group A β-haemolyticus streptococcus was found in 13 children (14%). Absence of cough, sore throat, tonsillar exudates and tender anterior cervical adenopathy were the clinical predictors for streptococcal pharyngitis and the last two shared highest risk (OR 55.05; 31.82). Combination of tonsillar exudates, tender anterior cervical adenopathy and absence of cough contributed 99,3% probability. Conclusions Streptococcal pharyngitis includes a small part of all childhood with acute pharyngitis. High grade fever, sore throat, absence of cough, tonsiller excudates and tender anterior cervical adenopathy were considered as clinical predictors for childhood streptococcal pharygitis. Combination of some clinical predictors will strengthen the probability of streptococcal pharyngitis.

Profile of Acute Pharyngitis at Dr. Soetomo General Hospital Pediatric Outpatients Clinic in 2013

“…18 here were different studies showed the highest prevalence based on age group, i.e. aged 3-6 years 13 and at the age of 5-9 years. 19 Epidemiologically, acute pharyngitis could occur at any ages, even though it mostly occurred at the age of 5-15 years and rarely occured at the age of <3 years.…”

“…12 However, these results were contrary to the study conducted in Padang, where acute pharyngitis mostly occurred in female (56%) than male (44%). 13 This condition was caused by there was no dominant gender for acute pharyngitis, so that both male and female had the same chance to get acute pharyngitis. 14 Acute pharyngitis mostly occurred at the age of 0-3 years, and rarely occurred at the age of 12-15 years.…”

Impact of an Antibiotic Stewardship Program on Antibiotic Prescription for Acute Respiratory Tract Infections in Children: A Prospective Before-After Study

“…In this study, we found that antibiotics were needed in only around 10% of visits for ARTI, which is similar to the findings of other studies. [20][21][22][23] Our antibiotic stewardship intervention, consisting of combined clinician education using e-mail and LINE as assisting tools and active monitoring, was associated with reduction of the rate of inappropriate antibiotic prescription for ARTI. Previous studies 12,24,25 showed that multifaceted interventions are the most successful tool for increasing appropriate antibiotic prescription.…”

Ketepatan Skoring McIsaac untuk Mengidentifikasi Faringitis Group A Streptococcus pada Anak

“…Temuan tersebut sejalan dengan hasil penelitian Syahroel dkk 34 di Padang dan beberapa penelitian lainnya. 25,[31][32][33] Rerata usia penelitian kami 7,85 (SB 3,08) tahun, sementara hasil penelitian Chiappini, 26 Attia dkk, 33 Syahroel dkk, 34 dan penelitian lain yang dilakukan oleh Rimoin di beberapa negara dengan pendapatan rendah seperti Brazil, Kroasia, dan Mesir menemukan rerata usia yang lebih muda. 25 Selain itu, kami juga menemukan kejadian faringitis GAS pada subjek dengan status gizi kurang dan keluarga dengan status sosial ekonomi rendah yang mungkin dihubungkan dengan lingkungan tempat tinggal yang padat.…”

“…9,13,25,34 Banyak faktor yang berperan pada kejadian faringitis GAS pada anak seperti jenis kelamin, usia, status nutrisi, dan musim. Timbulnya perbedaan antara hasil penelitian ini dengan penelitian lain yang dilakukan di berbagai tempat kemungkinan akibat adanya pengaruh terhadap faktor eksternal di masing-masing tempat tersebut sehingga penelitian di tempat yang berbeda akan menghasilkan karakteristik demografis yang berbeda pula.…”