EMPIRICAL USE OF ANTIBIOTICS FOR SORE THROAT – HOW RATIONAL IS IT?
Objective: To determine the frequency of Group A Streptococci culture positive cases among sore throat patients who were prescribed antibiotics
Study Design: Cross-sectional study.
Place and Duration of study: This study was conducted at Shifa College of Medicine, Islamabad and outpatient departments of two tertiary care hospitals of Islamabad from August to November 2015.
Materials and Methods: Throat swab cultures were done in cases prescribed empirical antibiotics for sore throat. All data regarding the physicians and patients, presenting complaints, clinical findings and prescriptions was recorded on a structured questionnaire. Frequencies and percentages were calculated for each variable in the questionnaire.
Results: A total of 151 adult patients, who presented with sore throat were enrolled for the study. Inflammation of posterior pharyngeal wall/tonsils was observed in 132 (87%) patients, while exudate was seen in 40 (27%) cases. Tonsils were enlarged in 9 (6%) cases, follicular tonsillitis was observed in 3 (2%) and cervical lymphadenopathy was present in 2 (1.3%) patients. All patients were prescribed empirical antibiotics. Among them, 55 (36.4%) received levofloxacin, 29 (19.2%) azithromycin, 25 (16.6%) amoxicillin/clavulanate potassium or a combination of these with a cephalosporin (27.8%). Group A Streptococci were isolated from throat swabs of only 3 (2%) patients.
Conclusion: Empirical prescription of antibiotics for sore throat in most cases is unjustified and the practice should be discouraged.Keywords: Pharyngitis, Antibiotics, Clinical practice patterns, Inappropriate prescribing.