Streptococcal Pharyngitis in Children

Miron, Victor Daniel; Bar, Gabriela; Filimon, Claudiu; Gaidamut, Vlad Alexandru; Craiu, Mihai

doi:10.4103/jgid.jgid_59_21

Cited by 3 publications

(4 citation statements)

References 5 publications

(6 reference statements)

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“…This might be due to inappropriate initiation of AMT for viral infection and/or without the clear clinical syndrome supporting the bacterial infection. 40 However, an inappropriate indication was the third commonly identified class of inappropriate AMT in the present study.…”

Section: Discussionmentioning

confidence: 58%

Risk Factors for Inappropriate Antimicrobial Therapy Among Patients with Hospital-Acquired Infection at Jimma Medical Center: A Prospective Observational Study

Debela¹,

Tesfaye²,

Yizengaw³

2022

IDR

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Background Globally, HAIs affect about 2 million people annually and result in 5% to 15% hospitalizations. In low-middle-income countries, antibiotics are improperly prescribed for 44% to 97% of hospitalized patients. A report in Ethiopia revealed that about 66.7% of HAIs are managed inappropriately. Objective To identify inappropriate antimicrobial therapy (AMT) and its risk factors among patients with HAIs at Jimma Medical Center (JMC). Methods A prospective observational study was conducted involving 300 patients with HAIs in medical, surgical, and gynecology-obstetrics wards of JMC, from October 2020 to April 2021. Data were collected using data abstraction format. Logistic regression was conducted to assess factors associated with AMT inappropriateness. A p-value <0.05 was considered to declare statistical significance. Results The overall mean age (± standard deviation) of the participants was 43.2 ± 19.2 years and 183 (61.0%) of them were females. About three-fourths (76.0%) of patients with HAIs were treated inappropriately. Hospital-acquired pneumonia (50.3%) was the most common type of HAI identified in this study. The frequent class of inappropriate AMT was an inappropriate choice, 102 (44.1%), followed by an inappropriate dose, 88 (38.1%), and inappropriate indication, 59 (24.2%). On multivariable logistic regression, patients having culture finding (AOR = 0.32, p = 0.016), taking metronidazole (AOR = 0.25, p = 0.001), and taking vancomycin (AOR = 2.93, p = 0.001) were significantly associated with inappropriate AMT. Conclusion Inappropriate AMT was identified in about three-fourths of the patients with HAIs. A decrease in the likelihood of inappropriate AMT was identified in patients having culture findings and in those taking metronidazole, whereas taking vancomycin increased the likelihood of inappropriate AMT. Therefore, the authors recommend scaling up the capacity of definitive therapy through culture and sensitivity tests. Furthermore, training of prescribers in the rational use of antimicrobials is also warranted.

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Section: Discussionmentioning

confidence: 58%

Risk Factors for Inappropriate Antimicrobial Therapy Among Patients with Hospital-Acquired Infection at Jimma Medical Center: A Prospective Observational Study

Debela¹,

Tesfaye²,

Yizengaw³

2022

IDR

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“…Distinguishing between viral and bacterial etiologies of acute pharyngitis can be problematic when attempting to make a correct diagnosis. Current statistics indicate that for acute pharyngitis and acute tonsillitis in children, less than 30% are of bacterial origin [ 4 , 5 ]. The highest peak incidence of GAS pharyngitis is observed during winter months.…”

Section: Introductionmentioning

confidence: 99%

“…The highest peak incidence of GAS pharyngitis is observed during winter months. In addition, an increased number of cases may also occur in spring and summer [ 4 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Toxic Streptococcal Infection in Children: Report on Two Cases with Uncharacteristic Course of Scarlet Fever

2023

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Introduction: Scarlet fever is usually a mild childhood disease caused by type A streptococci. This disease is spread by droplets, mainly through direct contact with an infected person or the objects they have used. In pediatrics, these are significant risk factors for the transmission of infectious diseases. However, it is important to remember the possibility of serious complications in the course of scarlet fever. Aim: This paper provides a discussion of two pediatric cases in order to determine the possibilities of diagnosis, differentiation, and treatment of patients with severe, non-obvious courses of scarlet fever. Methods: The case reports of two patients hospitalized in a pediatric department due to Streptococcus pyogenes infection were examined. Results: The patients were admitted to the emergency room with symptoms not directly indicative of type A streptococcal infection, which required further diagnosis. Both patients complained of weakness at the time of presentation. They had an elevated temperature, were dehydrated during the course of gastroenteritis, and passed liquid stools without pathological admixtures. Further stages of diagnosis and treatment required hospitalization in the pediatric department. Therapeutic benefit from the implemented treatment was obtained, and the patients were discharged in good general condition with further recommendations. Conclusions: Medical history, which is often very detailed, can be the key to making the final diagnosis and can supplement the data collected on the basis of laboratory tests. Scarlet fever does not always occur with a mild course, and sometimes its course can be quite non-specific and may require a thorough diagnosis.

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“…So far we know that viruses represent the most frequent etiology of acute pharyngitis, while only 30% of cases are bacterial in nature, Streptococcus pyogenes (group A streptococcus -GAS) being the leading bacterial agent involved. 2 However, the rate of antibiotic prescription in children with sore throat/"red throat" reaches over 60%. 3 It is therefore important to confirm the etiology of GAS before antibiotic treatment is recommended in a patient with acute pharyngitis.…”

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confidence: 99%

"Red throat” or acute pharyngitis – challenges in real life clinical practice

Miron¹,

Craiu²

2021

Germs

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An interesting article by Oksana Boyarchuk et al. has just been published in the current issue of Germs -"Diagnosis and management of pharyngitis in children: a survey study in Ukraine". 1 This study evaluated "the knowledge of pediatricians in diagnosis and management of sore throat in children" and the results showed "low knowledge about the diagnosis and determination of strategies in healthy carriers". 1The question we should ask when confronted with these results is whether this situation is isolated or is it common among doctors in other countries as well?Our clinical experience in Romania has shown that "red throat" is one of the most common diagnoses provided to febrile children (with or without sore throat) and one of the main drivers of antibiotic prescription. Is "red throat" a disease? Romanian doctors often explain the diagnosis of acute pharyngitis to parents with the expression "red throat". However, we believe that this label is too often used and does not always reflect the real diagnosis. The clinical examination of a febrile child can often reveal hyperemia of the tonsils and pharyngeal mucosa as result of general vascular changes during an inflammatory process. This is not necessarily equivalent to acute pharyngitis. The final diagnosis is a

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Streptococcal Pharyngitis in Children

Cited by 3 publications

References 5 publications

Risk Factors for Inappropriate Antimicrobial Therapy Among Patients with Hospital-Acquired Infection at Jimma Medical Center: A Prospective Observational Study

Risk Factors for Inappropriate Antimicrobial Therapy Among Patients with Hospital-Acquired Infection at Jimma Medical Center: A Prospective Observational Study

Toxic Streptococcal Infection in Children: Report on Two Cases with Uncharacteristic Course of Scarlet Fever

"Red throat” or acute pharyngitis – challenges in real life clinical practice

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