Evidence Based Practice in Using Antibiotics for Acute Tonsillitis in Primary Care Practice
| Autor: | Valentina Risteska Nejashmikj, Irena Kondova Topuzovska, Katarina Stavrikj, Snezana Stojkovska |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Antibiotics Tonsillitis Inappropriate Prescribing Young Adult 03 medical and health sciences 0302 clinical medicine Antibiotic resistance medicine Humans 030212 general & internal medicine Practice Patterns Physicians' Medical prescription Child Intensive care medicine Evidence-Based Medicine Primary Health Care Respiratory tract infections business.industry Acute Tonsillitis 030503 health policy & services General Medicine Evidence-based medicine Middle Aged medicine.disease Republic of North Macedonia Anti-Bacterial Agents Penicillin Child Preschool Acute Disease Practice Guidelines as Topic Female Guideline Adherence 0305 other medical science business medicine.drug |
| Zdroj: | PRILOZI. 38:63-68 |
| ISSN: | 1857-8985 1857-9345 |
| DOI: | 10.1515/prilozi-2017-0023 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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