Nationwide survey on the management of pediatric pharyngitis in Italian emergency units
Abstract Background Acute pharyngitis is a frequent reason for primary care or emergency unit visits in children. Most available data on pharyngitis management come from primary care studies that demonstrate an underuse of microbiological tests, a tendency to over-prescribe antibiotics and a risk of...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-09-01
|
| Series: | Italian Journal of Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13052-023-01514-8 |
| _version_ | 1797451981509361664 |
|---|---|
| author | Gregorio P. Milani Claudio Rosa Naz Tuzger Ilaria Alberti Chiara Ghizzi Stefania Zampogna Angela Amigoni Carlo Agostoni Diego Peroni Paola Marchisio Elena Chiappini IPSE study group |
| author_facet | Gregorio P. Milani Claudio Rosa Naz Tuzger Ilaria Alberti Chiara Ghizzi Stefania Zampogna Angela Amigoni Carlo Agostoni Diego Peroni Paola Marchisio Elena Chiappini IPSE study group |
| author_sort | Gregorio P. Milani |
| collection | DOAJ |
| description | Abstract Background Acute pharyngitis is a frequent reason for primary care or emergency unit visits in children. Most available data on pharyngitis management come from primary care studies that demonstrate an underuse of microbiological tests, a tendency to over-prescribe antibiotics and a risk of antimicrobial resistance increase. However, a comprehensive understanding of acute pharyngitis management in emergency units is lacking. This study aimed to investigate the frequency of rapid antigen test use to diagnose acute pharyngitis, as well as other diagnostic approaches, the therapeutic attitude, and follow-up of children with this condition in the emergency units. Methods A multicentric national study was conducted in Italian emergency departments between April and June 2022. Results A total of 107 out of 131 invited units (response rate 82%), participated in the survey. The results showed that half of the units use a scoring system to diagnose pharyngitis, with the McIsaac score being the most commonly used. Most emergency units (56%) were not provided with a rapid antigen diagnostic test by their hospital, but the test was more frequently available in units visiting more than 10,000 children yearly (57% vs 33%, respectively, p = 0.02). Almost half (47%) of the units prescribe antibiotics in children with pharyngitis despite the lack of microbiologically confirmed cases of Group A β-hemolytic streptococcus. Finally, about 25% of units prescribe amoxicillin-clavulanic acid to treat Group A β-hemolytic streptococcus pharyngitis. Conclusions The study sheds light on the approach to pharyngitis in emergency units, providing valuable information to improve the appropriate management of acute pharyngitis in this setting. The routinary provision of rapid antigen tests in the hospitals could enhance the diagnostic and therapeutic approach to pharyngitis. |
| first_indexed | 2024-03-09T15:02:15Z |
| format | Article |
| id | doaj.art-a89d9b8a921c4212a63b71486d5eb97d |
| institution | Directory Open Access Journal |
| issn | 1824-7288 |
| language | English |
| last_indexed | 2024-03-09T15:02:15Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj.art-a89d9b8a921c4212a63b71486d5eb97d2023-11-26T13:51:29ZengBMCItalian Journal of Pediatrics1824-72882023-09-014911710.1186/s13052-023-01514-8Nationwide survey on the management of pediatric pharyngitis in Italian emergency unitsGregorio P. Milani0Claudio Rosa1Naz Tuzger2Ilaria Alberti3Chiara Ghizzi4Stefania Zampogna5Angela Amigoni6Carlo Agostoni7Diego Peroni8Paola Marchisio9Elena Chiappini10IPSE study groupPediatric Unit, Foundation IRCCS Ca’ Granda, Ospedale Maggiore PoliclinicoDepartment of Clinical Sciences and Community Health, Università Degli Studi Di MilanoPediatric Unit, Foundation IRCCS Ca’ Granda, Ospedale Maggiore PoliclinicoPediatric Unit, Foundation IRCCS Ca’ Granda, Ospedale Maggiore PoliclinicoAUSL BolognaSOC Pediatria, Azienda Sanitaria Provinciale Di CrotonePediatric Intensive Care Unit, University Hospital of PaduaPediatric Unit, Foundation IRCCS Ca’ Granda, Ospedale Maggiore PoliclinicoDepartment of Clinical and Experimental Medicine, Section of Pediatrics, University of PisaPediatric Unit, Foundation IRCCS Ca’ Granda, Ospedale Maggiore PoliclinicoPediatric Infectious Disease Unit, Department of Health Sciences, Meyer Children’s University Hospital, University of FlorenceAbstract Background Acute pharyngitis is a frequent reason for primary care or emergency unit visits in children. Most available data on pharyngitis management come from primary care studies that demonstrate an underuse of microbiological tests, a tendency to over-prescribe antibiotics and a risk of antimicrobial resistance increase. However, a comprehensive understanding of acute pharyngitis management in emergency units is lacking. This study aimed to investigate the frequency of rapid antigen test use to diagnose acute pharyngitis, as well as other diagnostic approaches, the therapeutic attitude, and follow-up of children with this condition in the emergency units. Methods A multicentric national study was conducted in Italian emergency departments between April and June 2022. Results A total of 107 out of 131 invited units (response rate 82%), participated in the survey. The results showed that half of the units use a scoring system to diagnose pharyngitis, with the McIsaac score being the most commonly used. Most emergency units (56%) were not provided with a rapid antigen diagnostic test by their hospital, but the test was more frequently available in units visiting more than 10,000 children yearly (57% vs 33%, respectively, p = 0.02). Almost half (47%) of the units prescribe antibiotics in children with pharyngitis despite the lack of microbiologically confirmed cases of Group A β-hemolytic streptococcus. Finally, about 25% of units prescribe amoxicillin-clavulanic acid to treat Group A β-hemolytic streptococcus pharyngitis. Conclusions The study sheds light on the approach to pharyngitis in emergency units, providing valuable information to improve the appropriate management of acute pharyngitis in this setting. The routinary provision of rapid antigen tests in the hospitals could enhance the diagnostic and therapeutic approach to pharyngitis.https://doi.org/10.1186/s13052-023-01514-8Group A β-hemolytic streptococcus. ManagementAntibiotic stewardshipOver prescriptionTest |
| spellingShingle | Gregorio P. Milani Claudio Rosa Naz Tuzger Ilaria Alberti Chiara Ghizzi Stefania Zampogna Angela Amigoni Carlo Agostoni Diego Peroni Paola Marchisio Elena Chiappini IPSE study group Nationwide survey on the management of pediatric pharyngitis in Italian emergency units Italian Journal of Pediatrics Group A β-hemolytic streptococcus. Management Antibiotic stewardship Over prescription Test |
| title | Nationwide survey on the management of pediatric pharyngitis in Italian emergency units |
| title_full | Nationwide survey on the management of pediatric pharyngitis in Italian emergency units |
| title_fullStr | Nationwide survey on the management of pediatric pharyngitis in Italian emergency units |
| title_full_unstemmed | Nationwide survey on the management of pediatric pharyngitis in Italian emergency units |
| title_short | Nationwide survey on the management of pediatric pharyngitis in Italian emergency units |
| title_sort | nationwide survey on the management of pediatric pharyngitis in italian emergency units |
| topic | Group A β-hemolytic streptococcus. Management Antibiotic stewardship Over prescription Test |
| url | https://doi.org/10.1186/s13052-023-01514-8 |
| work_keys_str_mv | AT gregoriopmilani nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT claudiorosa nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT naztuzger nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT ilariaalberti nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT chiaraghizzi nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT stefaniazampogna nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT angelaamigoni nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT carloagostoni nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT diegoperoni nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT paolamarchisio nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT elenachiappini nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits AT ipsestudygroup nationwidesurveyonthemanagementofpediatricpharyngitisinitalianemergencyunits |