Antti Kunnamo1, Matti Korppi2, Merja Helminen1. 1. Pediatric Research Center, Tampere University and Univesity Hospital, Tampere, Finland. 2. Pediatric Research Center, Tampere University and Univesity Hospital, Tampere, Finland. matti.korppi@uta.fi.
Abstract
BACKGROUND: The Finnish Current Care Guidelines on diagnostics and treatment of sore throat recommend the treatment of only group A streptococcus (GAS) positive cases with penicillin. The aim of the study was to evaluate how these guidelines are followed in the pediatric emergency unit. METHODS: We analyzed retrospectively the data on microbiological studies and blood tests done, and data on prescribing of antibiotics, of 200 children admitted for febrile exudative tonsillitis. RESULTS: After the clinical diagnosis of exudative tonsillitis, antigen test and/or culture for GAS identification was done in >95% of cases. All the 32 (16%) children with GAS infection, but also 52 (38%) of the 137 children without any evidence of bacterial infection received antibiotics. Additional laboratory studies were done in 96% of children. Serum C-reactive concentrations or white blood cell counts were not able to separate streptococcal from non-streptococcal tonsillitis. No serious bacterial infection was diagnosed. CONCLUSIONS: The Finnish Current Care Guidelines lead to over-treatment with antibiotics. None of the 200 children returned after discharge, suggesting that undertreatment did not happen.
BACKGROUND: The Finnish Current Care Guidelines on diagnostics and treatment of sore throat recommend the treatment of only group A streptococcus (GAS) positive cases with penicillin. The aim of the study was to evaluate how these guidelines are followed in the pediatric emergency unit. METHODS: We analyzed retrospectively the data on microbiological studies and blood tests done, and data on prescribing of antibiotics, of 200 children admitted for febrile exudative tonsillitis. RESULTS: After the clinical diagnosis of exudative tonsillitis, antigen test and/or culture for GAS identification was done in >95% of cases. All the 32 (16%) children with GAS infection, but also 52 (38%) of the 137 children without any evidence of bacterial infection received antibiotics. Additional laboratory studies were done in 96% of children. Serum C-reactive concentrations or white blood cell counts were not able to separate streptococcal from non-streptococcal tonsillitis. No serious bacterial infection was diagnosed. CONCLUSIONS: The Finnish Current Care Guidelines lead to over-treatment with antibiotics. None of the 200 children returned after discharge, suggesting that undertreatment did not happen.
Authors: Alan L Bisno; Michael A Gerber; Jack M Gwaltney; Edward L Kaplan; Richard H Schwartz Journal: Clin Infect Dis Date: 2002-07-15 Impact factor: 9.079
Authors: T Matthew Eison; Bettina H Ault; Deborah P Jones; Russell W Chesney; Robert J Wyatt Journal: Pediatr Nephrol Date: 2010-07-23 Impact factor: 3.714