Association between bacterial finding, antibiotic treatment and clinical course in patients with pharyngotonsillitis: a registry-based study in primary healthcare in Sweden

Autor:	Martin Sundqvist, Mattias Rööst, Jon Pallon, Katarina Hedin
Rok vydání:	2021
Předmět:	Adult medicine.medical_specialty Infectious Medicine Adolescent medicine.drug_class Streptococcus pyogenes medicine.medical_treatment Antibiotics Infektionsmedicin Infectious and parasitic diseases RC109-216 Medical microbiology Throat Internal medicine Streptococcal Infections Pharyngotonsillitis medicine Humans Prospective Studies Registries Medical prescription Aetiology Prospective cohort study Retrospective Studies Sweden Primary Health Care business.industry Research Streptococcus dysgalactiae subspecies equisimilis Infant Newborn Streptococcus Pharyngitis Tonsillectomy Anti-Bacterial Agents Infectious Diseases medicine.anatomical_structure Fusobacterium necrophorum Group A streptococci Primary healthcare Cohort Etiology Female business
Zdroj:	BMC Infectious Diseases, Vol 21, Iss 1, Pp 1-11 (2021) BMC Infectious Diseases
ISSN:	1471-2334
Popis:	Background The role of non-group A streptococci and Fusobacterium necrophorum in pharyngotonsillitis has been disputed and few prospective studies have evaluated the effect of antibiotic treatment. This study uses registry data to investigate the relation between antibiotic prescription for pharyngotonsillitis in primary healthcare and return visits for pharyngotonsillitis, complications, and tonsillectomy. Methods Retrospective data were extracted from the regional electronic medical record system in Kronoberg County, Sweden, for all patients diagnosed with pharyngotonsillitis between 2012 and 2016. From these data, two cohorts were formed: one based on rapid antigen detection tests (RADT) for group A streptococci (GAS) and one based on routine throat cultures for β-haemolytic streptococci and F. necrophorum. The 90 days following the inclusion visit were assessed for new visits for pharyngotonsillitis, complications, and tonsillectomy, and related to bacterial aetiology and antibiotic prescriptions given at inclusion. Results In the RADT cohort (n = 13,781), antibiotic prescription for patients with a positive RADT for GAS was associated with fewer return visits for pharyngotonsillitis within 30 days compared with no prescription (8.7% vs. 12%; p = 0.02), but not with the complication rate within 30 days (1.5% vs. 1.8%; p = 0.7) or with the tonsillectomy rate within 90 days (0.27% vs. 0.26%; p = 1). In contrast, antibiotic prescription for patients with a negative RADT was associated with more return visits for pharyngotonsillitis within 30 days (9.7% vs. 7.0%; p = 0.01). In the culture cohort (n = 1 370), antibiotic prescription for patients with Streptococcus dysgalactiae ssp. equisimilis was associated with fewer return visits for pharyngotonsillitis within 30 days compared with no prescription (15% vs. 29%; p = 0.03). Conclusions Antibiotic prescription was associated with fewer return visits for pharyngotonsillitis in patients with a positive RADT for GAS but with more return visits in patients with a negative RADT for GAS. There were no differences in purulent complications related to antibiotic prescription.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8f7f73355af585c0eb5c6afcc4354b2a https://pubmed.ncbi.nlm.nih.gov/34372771 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.