Assessment of Adherence to Guidelines for Testing and Treatment of Pharyngitis among Children in Palestine: A Retrospective Study

Background Acute Pharyngitis is a common upper respiratory tract infection, and is considered to be one of the leading causes for paediatric outpatient visits. Bacterial pharyngitis is less common and is mainly caused by Group A Beta haemolytic streptococcus (GABHS), also known as Streptococcus pyogenes . Accurate diagnosis guided by appropriate diagnostic tools is essential in managing paediatric pharyngitis as antibiotics are indicated only for documented bacterial cases. This researched aimed to assess the extent of physicians’ adherence to clinical guidelines regarding the testing and management of pharyngitis among children in Palestine. Method A retrospective, observational study that was conducted at the Palestine Medical Complex (PMC). Data were collected from the emergency department between June and December 2019. The Modified Centor score was used to assess the extent of physicians’ adherence to guidelines regarding pharyngitis testing and management among children 3 to 13 years old. It included assessing throat swab collection and antibiotics prescribing. SPSS was used for data analysis. Results A total of 290 cases were collected. 217 patients (74 .8 %) had a Modified Centor score of ≥ 2; 126 of them received antibiotics and swab was taken for only 8 of them. On the other hand, 73 cases (25.2 %) had a Modified Centor score of < 2; 34 of them received antibiotics. Azithromycin was the most commonly prescribed antibiotic (41.3%), followed by Amoxicillin-clavulanic acid (38.1%). The frequency of empirical antibiotics prescribing was significantly higher among children with Centor score >2, elder children and those presenting with fever. Conclusion Pharyngitis management should include appropriate swab collection and antibiotic selection. Prescribing antibiotics empirically early on for most patients with pharyngitis will hasten the development of bacterial resistance and will increase the cost of treatment without adding any benefit in terms of protecting patients from pharyngitis complications.