The Effect of Rapid Antigen Detection Test on Antibiotic Prescription Decision of Clinicians and Reducing Antibiotic Costs in Children with Acute Pharyngitis

Köse, Engi̇n; Köse, Seda Şirin; Akca, Deniz; Yıldız, Kerem; Elmas, Cengizhan; Barış, Mustafa; Anıl, Murat

doi:10.1093/tropej/fmw014

Cited by 23 publications

(18 citation statements)

References 26 publications

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“…Similarly in previous studies, RSAT was associated with 22.4% antibiotic prescription for children with pharyngitis compared to 41.4% for those who did not have RSAT. [4041] RSAT is an easy and sensitive test that is available at the point-of-care testing and could be utilized to decrease inappropriate antibiotic use. [4243]…”

Section: Discussionmentioning

confidence: 99%

A multifaceted approach to decrease inappropriate antibiotic use in a pediatric outpatient clinic

Al‐Tawfiq

Alawami

2017

Ann Thorac Med

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BACKGROUND:Inappropriate use of antimicrobial agents is the major cause for the development of resistance. Thus, it is important to include outpatient clinics in the development of antibiotic stewardship program.METHODS:We report a multifaceted approach to decrease inappropriate antibiotic use in upper respiratory tract infections (URTIs) in an outpatient pediatric clinic. The interventions included educational grand round, academic detailing, and prospective audit and feedback and peer comparison.RESULTS:During the study period, a total of 3677 outpatient clinic visits for URTIs were evaluated. Of all the included patients, 12% were <1 year of age, 42% were 1–5 years, and 46% were >5 years of age. Of the total patients, 684 (17.6%) received appropriate antibiotics, 2812 (76.4%) appropriately did not receive antibiotics, and 217 (6%) inappropriately received antibiotics. The monthly rate of prescription of inappropriate antibiotics significantly decreased from 12.3% at the beginning of the study to 3.8% at the end of the study (P < 0.0001). Antibiotic prescription among those who had rapid streptococcal antigen test (RSAT) was 40% compared with 78% among those who did not have RSAT (P < 0.0001).CONCLUSIONS:The combination of education and academic detailing is important to improve antibiotic use.

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Section: Discussionmentioning

confidence: 99%

A multifaceted approach to decrease inappropriate antibiotic use in a pediatric outpatient clinic

Al‐Tawfiq

Alawami

2017

Ann Thorac Med

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“…[ 17,18 ] Using the guidelines and the Centor score criteria can have an important impact on the treatment decisions by the doctors in the PHC, on the emergence of the antibiotic resistance; it can prevent the adverse effects of the antibiotics and reduce the unnecessary antibiotic prescriptions and antibiotic costs. [ 13,19,20] Antibiotic prescriptions for acute tonsillitis corresponded poor with the recommended firstline choice in 23.6% of all prescriptions. The use of broad-spectrum antibiotics such as amoxicillin/clavulanic acid and cephalosporin second and third generation accounted for 39.6% and 9.4% of the GPs' prescriptions.…”

Section: Resultsmentioning

confidence: 99%

Evidence Based Practice in Using Antibiotics for Acute Tonsillitis in Primary Care Practice

Nejashmikj¹,

Stojkovska

Topuzovska

et al. 2017

Prilozi

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The increased use of antibiotics for acute tonsillitis is a public health problem. 80% of the antibiotic prescriptions for acute tonsillitis are done in the Primary Care practice (PCP). The inappropriate use of the antibiotic causes bacterial resistance and treatment failure. Only patients with acute tonsillitis caused by Group A beta-hemolytic streptococcus (GAS) have benefit of the antibiotic treatment, which is a predict cause in 5-20%. In order to assess the antibiotic prescribing for acute tonsillitis by the doctors in the PCP in Macedonia we use the data from the national project about antibiotic prescribing for acute respiratory tract infections which was conducted in November 2014 during a period of 4 weeks as part of the E-quality program sponsored by the IPCRG. 86 general practitioners from Macedonia have participated. The group of 1768 patients, from 4 months to 88 years of age, with diagnosis of acute tonsillitis was analyzed. The antibiotic prescriptions according to the Centor score criteria were compared to the Cochran's guidelines which are translated and recommended as national guidelines. 88.8% of the patients with acute tonsillitis were treated with antibiotics, of which 52.9% with Centor score 0 to 2 were treated inappropriate. The diagnosis is mostly made based on the clinical picture and the symptoms. Only (23.6%) of the patients were treated with antibiotics (Penicillin V and cephalexin) according to the guidelines. We concluded that there is a low adherence to the national guidelines. The clinical assessment is not accurate in determining the etiology. Also, there is a high nonadherence in prescribing the first choice of antibiotics. We emphasize the need to change the general practitioners' prescription behavior according to the guidelines.

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“…One research team estimated that diagnosing GABHS without a RADT may lead to more than 40% of adult patients being prescribed antibiotics unnecessarily ( McIsaac et al., 2004 ). An investigation of pediatrician behavior reported that antibiotic prescription rates for children fell by forty-two percentage points after doctors were given the results of RADTs ( Kose et al., 2016 ). These results have been confirmed in randomized control trials of RADTs, which conclude that physicians who use RADTs prescribe antibiotics at lower rates than physicians who do not ( Worrall et al., 2007 ; Llor et al., 2011 ; Cohen et al., 2020 ).…”

Section: Clinical Guidelines For Gabhsmentioning

confidence: 99%

Diagnostic Methods, Clinical Guidelines, and Antibiotic Treatment for Group A Streptococcal Pharyngitis: A Narrative Review

Mustafa

Ghaffari

2020

Front. Cell. Infect. Microbiol.

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The most common bacterial cause of pharyngitis is infection by Group A b-hemolytic streptococcus (GABHS), commonly known as strep throat. 5-15% of adults and 15-35% of children in the United States with pharyngitis have a GABHS infection. The symptoms of GABHS overlap with non-GABHS and viral causes of acute pharyngitis, complicating the problem of diagnosis. A careful physical examination and patient history is the starting point for diagnosing GABHS. After a physical examination and patient history is completed, five types of diagnostic methods can be used to ascertain the presence of a GABHS infection: clinical scoring systems, rapid antigen detection tests, throat culture, nucleic acid amplification tests, and machine learning and artificial intelligence. Clinical guidelines developed by professional associations can help medical professionals choose among available techniques to diagnose strep throat. However, guidelines for diagnosing GABHS created by the American and European professional associations vary significantly, and there is substantial evidence that most physicians do not follow any published guidelines. Treatment for GABHS using analgesics, antipyretics, and antibiotics seeks to provide symptom relief, shorten the duration of illness, prevent nonsuppurative and suppurative complications, and decrease the risk of contagion, while minimizing the unnecessary use of antibiotics. There is broad agreement that antibiotics with narrow spectrums of activity are appropriate for treating strep throat. But whether and when patients should be treated with antibiotics for GABHS remains a controversial question. There is no clearly superior management strategy for strep throat, as significant controversy exists regarding the best methods to diagnose GABHS and under what conditions antibiotics should be prescribed.

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The Effect of Rapid Antigen Detection Test on Antibiotic Prescription Decision of Clinicians and Reducing Antibiotic Costs in Children with Acute Pharyngitis

Cited by 23 publications

References 26 publications

A multifaceted approach to decrease inappropriate antibiotic use in a pediatric outpatient clinic

A multifaceted approach to decrease inappropriate antibiotic use in a pediatric outpatient clinic

Evidence Based Practice in Using Antibiotics for Acute Tonsillitis in Primary Care Practice

Diagnostic Methods, Clinical Guidelines, and Antibiotic Treatment for Group A Streptococcal Pharyngitis: A Narrative Review

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