Effect of a standardized pharyngitis treatment protocol on use of antibiotics in a pediatric emergency department.

Title

Effect of a standardized pharyngitis treatment protocol on use of antibiotics in a pediatric emergency department.

Creator

Diaz Maria Carmen G; Symons Nadine; Ramundo Maria L; Christopher Norman C

Publisher

Archives of Pediatrics & Adolescent Medicine

Date

2004
2004-10

Description

BACKGROUND: Pharyngitis is a common complaint in pediatric patients. If clinical parameters are used alone, bacterial pathogens will be wrongly implicated in many cases. A nonstandardized approach to the treatment of children with pharyngitis in an emergency department setting may lead to inappropriate empirical therapy, contribute to increased bacterial resistance, and result in adverse events related to the treatment provided. OBJECTIVE: To implement evidence-based guidelines for the diagnosis and treatment of children with pharyngitis in an emergency department setting and thereby influence practices of prescribing antibiotics. DESIGN AND METHODS: An evidence-based guideline for the evaluation and treatment of patients with pharyngitis was developed and implemented in our emergency department. Preintervention and postintervention patient cohorts were identified by a search of the emergency department's clinical repository. A medical record review was performed using a standardized data abstraction form (history and examination data, diagnostic testing, and therapy provided). Treatment decisions were judged as appropriate if the diagnosis of pharyngitis caused by group A beta-hemolytic streptococci was based on confirmatory microbiological testing rather than on the history and physical examination findings alone. RESULTS: We included 443 patients for study (219 preintervention and 224 postintervention). In the preintervention group, 97 (44%) of 214 received appropriate treatment. In the postintervention group, 204 (91%) of 224 received appropriate treatment. CONCLUSION: An evidence-based clinical guideline can influence and improve practices of prescribing antibiotics by pediatric emergency physicians in a teaching hospital setting.

Subject

*Emergency Service; *Practice Guidelines as Topic; Adolescent; Adult; Anti-Bacterial Agents/*therapeutic use; Child; Cohort Studies; Dose-Response Relationship; Drug; Drug Administration Schedule; Evidence-Based Medicine; Female; Follow-Up Studies; Hospital; Hospitals; Humans; Male; Pediatric; Pharyngitis/*drug therapy/*microbiology; Preschool; Streptococcal Infections/*drug therapy/microbiology; Treatment Outcome

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

977–981

Issue

10

Volume

158

Citation

Diaz Maria Carmen G; Symons Nadine; Ramundo Maria L; Christopher Norman C, “Effect of a standardized pharyngitis treatment protocol on use of antibiotics in a pediatric emergency department.,” NEOMED Bibliography Database, accessed January 23, 2021, https://neomed.omeka.net/items/show/2894.

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