Appropriateness and Pattern of Antibiotics Prescribed to Patients with Acute Pharyngitis in a Secondary Care Hospital
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Abstract
Objective: To study the appropriateness and pattern of antibiotic use in patients with acute pharyngitis using the Centor criteria. Method: The investigators identified patients diagnosed with acute pharyngitis and received treatment during January 1 to June 30, 2017, from the database of the outpatient department of a secondary hospital. The researchers assessed the appropriateness of prescribed antibiotics to the patients with the Centor criteria. Results: 346 patients received antibiotics (87.9%). In nine (3.0%) patients, the prescribing was regarded as appropriate. Among 42 patients (12.1%) receiving no antibiotics, 41 (97.6%) did not need antibiotics. One case (2.4%) required medication but did not receive it. The most commonly prescribed antibiotics was amoxicillin. The most prevalent pattern of prescribing was 2 capsules of 500 mg amoxicillin twice a day for 5 days. No patients received the drug with 1,000 mg dose as recommended by the guideline. Conclusion: More than 90% of patients with acute pharyngitis did not need antibiotics. The study found that the use of antibiotics was not appropriate according to the treatment guidelines in terms of dose and duration of treatment. This may affect the treatment outcomes, adverse drug reactions and the increased chances of antibiotic resistance.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
2. Choby BA. Diagnosis and treatment of streptococcal pharyngitis. Am Fam Physician 2009;79:383-90.
3. Chongtrakul P. Antibiotics smart use. 2nd ed. Bang kok: Graphic and design; 2011.
4. Centor RM, Witherspoon JM, Dalton HP, Brody CE , Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making 1981; 1: 239-46.
5. Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, et al. Guideline for the mana- gement of acute sore throat. Clin Microbiol Infect 2012; 18: 1-28.
6. Fine AM, Nizet V, Mandl KD. Large-scale validation of the Centor and McIsaac scores to predict group A Streptococcal Pharyngitis. Arch Intern Med 2012 ; 172: 847–52.
7. Saengcharoen W, Lerkiatbundit S. Sore throat from acute pharyngitis. Thai Pharm Health Sci J 2012; 7: 52-9.
8. Sub-Committee on Rational Drug Use Promotion. Rational drug use hospital manual. Bangkok: Agri cultural Cooperatives of Thailand Printing; 2015.
9. Uruekoran R, Phonsena W, Thongdang, Somsaard P, Chaiyasong S, Srisilp T. Treatment outcome and cost of rationale antibiotic use implementation in Mahasarakham University Pharmacy. Isan Journal of Pharmaceutical Sciences 2013;9:31-42.
10. McIsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998;158:75–83
11. Palla AH, Khan RA, Gilani AH, Marra F. Over prescription of antibiotics for adult pharyngitis is prevalent in developing countries but can be reduced using McIsaac modification of Centor scores: a cross-sectional study. BMC Pulm Med 2012; 12: 1-7
12. Yuniar CT, Anggadiredja K, Islamiyah AN. Evalu- ation of rational drug use for acute pharynxgitis associated with the incidence and prevalence of the disease at two community health centers in Indonesia. Sci Pharm 2017; 85: 1-10.
13. Acerra JR. Pharyngitis [online]. 2018 [cited Jan 9, 2018]. Available from: emedicine.medscape.com/ article/764304-clinical
14. Casey JR, Pichichero ME. Meta-analysis of short course antibiotic treatment for group a streptococ cal tonsillopharyngitis. Pediatr Infect Dis J 2005; 24: 909-17.
15. Cohen R. Defining the optimum treatment regimen for azithromycin in acute tonsillopharyngitis. Pediatr Infect Dis J 2004;23:S129-34.
16. Seppala H, Nissinen A, Jarvinen H, et al. Resist- ance to erythromycin in group A streptococci. N Engl J Med 1992;326:292–7.
17. Tanz RR, Shulman ST, Shortridge VD, et al. Community-based surveillance in the united states of macrolide-resistant pediatric pharyngeal group A streptococci during 3 respiratory disease seasons. Clin Infect Dis 2004;39:1794–801.
18. Jasir A, Tanna A, Noorani A, Mirsalehian A, Efstratiou A, Schalen C. High rate of tetracycline resistance in Streptococcus pyogenes in Iran: an epidemiological study. J Clin Microbiol 2000; 38: 2103-7.
