Standard of care in the treatment of tonsilopharyngitis in children in Canton Sarajevo

Amela Paščaninović, Maida Rakanović-Todić, Sanita Maleškić, Aida Kulo Ćesić, Jasna Kusturica, Lejla Burnazović-Ristić

Abstract


Objective: Inappropriate use of antibiotics is one of the major
causes of resistance, and it is recognized as one of today’s most
significant medical issue. Per standard of care antimicrobic treatment
is not recommended for uncomplicated acute infections of
the upper respiratory tract. However, despite this fact the most of
antibiotics in ambulatory use are prescribed in these indications.
The main objectives of this research was to evaluate the frequency
of use of throat swabs in diagnostic purposes and subsequently
prescribed antibiotic therapy in children with the diagnosis of
bacterial tonsillitis or angina.
Methods: An observational, retrospective study was conducted
in the pediatric departments in of the Public Health Center of
Canton Sarajevo. Data were collected from the available medical
records sourced with relevant info on diagnostic swabs for
upper respiratory infections and the applied treatment.
Results: Data from 100 patients preschool and school age were
collected. Results suggest that a significantly more frequent use
of throat swabs is proven in preschool children compared to
school age (p=0.008; χ²=7.100). In addition, results indicate
that the prescription of beta-lactam antibiotics is preferred option
of the treatment of tonsillitis and angina in whole sample.
The preschoolers were more often prescribed cephalosporin
antibiotics while school age children were the most frequently
treated with the penicillin.
Conclusion: Streptococcus is detected in 35–50% of cases of
clinically diagnosed streptococcal pharyngitis, which makes the
bacteriological confirmation of the agent necessary. Penicillin is
recommended as the medication of the first choice for streptococcal
tonsillopharyngitis. Also, the research reveals common
appearance of mixed infections as a reason for preferred prescription
of macrolides and cephalosporins.
Keywords: tonsilopharyngitis, antibiotics, resistance


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