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Nationwide survey on the management of pediatric pharyngitis in Italian emergency units

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 antimic...

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Autores principales: Milani, Gregorio P., Rosa, Claudio, Tuzger, Naz, Alberti, Ilaria, Ghizzi, Chiara, Zampogna, Stefania, Amigoni, Angela, Agostoni, Carlo, Peroni, Diego, Marchisio, Paola, Chiappini, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481466/
https://www.ncbi.nlm.nih.gov/pubmed/37670391
http://dx.doi.org/10.1186/s13052-023-01514-8
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author Milani, Gregorio P.
Rosa, Claudio
Tuzger, Naz
Alberti, Ilaria
Ghizzi, Chiara
Zampogna, Stefania
Amigoni, Angela
Agostoni, Carlo
Peroni, Diego
Marchisio, Paola
Chiappini, Elena
author_facet Milani, Gregorio P.
Rosa, Claudio
Tuzger, Naz
Alberti, Ilaria
Ghizzi, Chiara
Zampogna, Stefania
Amigoni, Angela
Agostoni, Carlo
Peroni, Diego
Marchisio, Paola
Chiappini, Elena
author_sort Milani, Gregorio P.
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-023-01514-8.
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spelling pubmed-104814662023-09-07 Nationwide survey on the management of pediatric pharyngitis in Italian emergency units Milani, Gregorio P. Rosa, Claudio Tuzger, Naz Alberti, Ilaria Ghizzi, Chiara Zampogna, Stefania Amigoni, Angela Agostoni, Carlo Peroni, Diego Marchisio, Paola Chiappini, Elena Ital J Pediatr Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-023-01514-8. BioMed Central 2023-09-05 /pmc/articles/PMC10481466/ /pubmed/37670391 http://dx.doi.org/10.1186/s13052-023-01514-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Milani, Gregorio P.
Rosa, Claudio
Tuzger, Naz
Alberti, Ilaria
Ghizzi, Chiara
Zampogna, Stefania
Amigoni, Angela
Agostoni, Carlo
Peroni, Diego
Marchisio, Paola
Chiappini, Elena
Nationwide survey on the management of pediatric pharyngitis in Italian emergency units
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 Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481466/
https://www.ncbi.nlm.nih.gov/pubmed/37670391
http://dx.doi.org/10.1186/s13052-023-01514-8
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