Evaluation of Differential Diagnosis of Acute Pharyngitis and Tonsillitis by Using a Scoring Tool to Predict the risk of Group A Streptococci infection in a Community Hospital
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Abstract
Objective: To assess the use of scoring tools for predicting the risk of infection with Group A Streptococci, including the Centor score, the McIsaac score and the FeverPAIN for the differential diagnosis of acute pharyngitis and acute tonsillitis. Methods: This research was a retrospective descriptive study during October 1, 2017 to March 31, 2019 at a community hospital. The study collected clinical data of outpatients diagnosed with acute pharyngitis and acute tonsillitis from electronic database of the hospital. Results: Number of visits of eligible outpatients diagnosed with acute pharyngitis and acute tonsillitis was 1,228. When using all 3 tools i.e., the Centor score, the McIsaac score and the FeverPAIN to assess patients with the cut points for antibiotic prescribing at 3-4, ≥4 and ≥ 4, respectively, numbers of visits with the scores reaching the levels for antibiotic prescribing were 106, 63 and 98, accounting for 8.63%, 5.13% and 7.98% of the total visits, respectively. The McIsaac score resulted in the lowest proportion of visits with the decision to prescribe antibiotics. 65.02% of antibiotic prescribing involved the drugs recommended by the guideline for treating these diseases including amoxicillin, cephalexin, azithromycin, roxithromycin, and clindamycin. Conclusion: Antibiotic prescribing at the community hospital being the study site was not consistent to the recommendations in standard treatment guidelines for acute pharyngitis and acute tonsillitis in terms of indications, drugs and duration of treatment. The McIsaac score is a tool to predict the risk of infection with Group A Streptococci with the lowest proportion of patients having the score reaching the level for antibiotic prescribing.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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