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Treatment of Pharyngitis in Uninsured Patients: A Multicenter Study of Free Clinics
Introduction Appropriate antibiotic prescription practices for pharyngitis slow anti-microbial resistance. Unnecessary antibiotic prescribing and non-adherence to practice guidelines remain a clinical problem. The objective of this study was to examine the relationship between group A Streptococcus...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571809/ https://www.ncbi.nlm.nih.gov/pubmed/34760411 http://dx.doi.org/10.7759/cureus.18564 |
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author | Nguyen, Matthew Dyjak, Patrick MacDonald, Madeline Vivar, Jhulianna Shah, Shreni Swanson, Justin Pruitt, Zachary Mirza, Abu-Sayeef Mhaskar, Rahul |
author_facet | Nguyen, Matthew Dyjak, Patrick MacDonald, Madeline Vivar, Jhulianna Shah, Shreni Swanson, Justin Pruitt, Zachary Mirza, Abu-Sayeef Mhaskar, Rahul |
author_sort | Nguyen, Matthew |
collection | PubMed |
description | Introduction Appropriate antibiotic prescription practices for pharyngitis slow anti-microbial resistance. Unnecessary antibiotic prescribing and non-adherence to practice guidelines remain a clinical problem. The objective of this study was to examine the relationship between group A Streptococcus (GAS) throat culture testing and antibiotic prescriptions at 10 free clinics in the Tampa Bay Area serving the uninsured population. Methods A retrospective cohort study was conducted using data from patient charts from January 2018 to December 2019. We obtained data regarding a chief complaint related to strep pharyngitis: sore throat, enlarged tonsils, pharyngeal erythema, and/or cervical lymphadenopathy. The frequency and relative proportions of throat swab administration and antibiotic prescription were also analyzed. Results Of the 12,005 patients serviced during the study period, 245 (2.0%) reported one or more of the chief complaints related to strep pharyngitis. Of the patients reporting pharyngitis, the mean age was 40.2 years, with 66% being female. Of the patients receiving antibiotics for pharyngitis symptoms, 93 (91.2%) did not receive a throat swab. Patients receiving a throat swab showed a significantly increased odds of antibiotic prescription (OR=3.4, 95% CI: 1.1-12.7). Patients reporting symptoms of pharyngitis commonly had other comorbidities, including smoking (14.7%) and diabetes (13.5%). Conclusion The large proportion of patients receiving antibiotics for pharyngitis symptoms reveals the need for provider counseling on current recommendations of antibiotic prescription practices, which state that a throat swab with a rapid antigen detection test and/or culture should be performed for all patients where bacterial symptoms of rhinorrhea, cough, and/or oral ulcers are present. Another potential area of improvement indicated by this study may be providing additional supplies of throat swabs for these underserved clinics. Further research is needed to understand the root causes of providers' non-compliant prescribing patterns in the free clinics and to assess the role of the uninsured population in reducing anti-microbial resistance. |
format | Online Article Text |
id | pubmed-8571809 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-85718092021-11-09 Treatment of Pharyngitis in Uninsured Patients: A Multicenter Study of Free Clinics Nguyen, Matthew Dyjak, Patrick MacDonald, Madeline Vivar, Jhulianna Shah, Shreni Swanson, Justin Pruitt, Zachary Mirza, Abu-Sayeef Mhaskar, Rahul Cureus Family/General Practice Introduction Appropriate antibiotic prescription practices for pharyngitis slow anti-microbial resistance. Unnecessary antibiotic prescribing and non-adherence to practice guidelines remain a clinical problem. The objective of this study was to examine the relationship between group A Streptococcus (GAS) throat culture testing and antibiotic prescriptions at 10 free clinics in the Tampa Bay Area serving the uninsured population. Methods A retrospective cohort study was conducted using data from patient charts from January 2018 to December 2019. We obtained data regarding a chief complaint related to strep pharyngitis: sore throat, enlarged tonsils, pharyngeal erythema, and/or cervical lymphadenopathy. The frequency and relative proportions of throat swab administration and antibiotic prescription were also analyzed. Results Of the 12,005 patients serviced during the study period, 245 (2.0%) reported one or more of the chief complaints related to strep pharyngitis. Of the patients reporting pharyngitis, the mean age was 40.2 years, with 66% being female. Of the patients receiving antibiotics for pharyngitis symptoms, 93 (91.2%) did not receive a throat swab. Patients receiving a throat swab showed a significantly increased odds of antibiotic prescription (OR=3.4, 95% CI: 1.1-12.7). Patients reporting symptoms of pharyngitis commonly had other comorbidities, including smoking (14.7%) and diabetes (13.5%). Conclusion The large proportion of patients receiving antibiotics for pharyngitis symptoms reveals the need for provider counseling on current recommendations of antibiotic prescription practices, which state that a throat swab with a rapid antigen detection test and/or culture should be performed for all patients where bacterial symptoms of rhinorrhea, cough, and/or oral ulcers are present. Another potential area of improvement indicated by this study may be providing additional supplies of throat swabs for these underserved clinics. Further research is needed to understand the root causes of providers' non-compliant prescribing patterns in the free clinics and to assess the role of the uninsured population in reducing anti-microbial resistance. Cureus 2021-10-07 /pmc/articles/PMC8571809/ /pubmed/34760411 http://dx.doi.org/10.7759/cureus.18564 Text en Copyright © 2021, Nguyen et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Family/General Practice Nguyen, Matthew Dyjak, Patrick MacDonald, Madeline Vivar, Jhulianna Shah, Shreni Swanson, Justin Pruitt, Zachary Mirza, Abu-Sayeef Mhaskar, Rahul Treatment of Pharyngitis in Uninsured Patients: A Multicenter Study of Free Clinics |
title | Treatment of Pharyngitis in Uninsured Patients: A Multicenter Study of Free Clinics |
title_full | Treatment of Pharyngitis in Uninsured Patients: A Multicenter Study of Free Clinics |
title_fullStr | Treatment of Pharyngitis in Uninsured Patients: A Multicenter Study of Free Clinics |
title_full_unstemmed | Treatment of Pharyngitis in Uninsured Patients: A Multicenter Study of Free Clinics |
title_short | Treatment of Pharyngitis in Uninsured Patients: A Multicenter Study of Free Clinics |
title_sort | treatment of pharyngitis in uninsured patients: a multicenter study of free clinics |
topic | Family/General Practice |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571809/ https://www.ncbi.nlm.nih.gov/pubmed/34760411 http://dx.doi.org/10.7759/cureus.18564 |
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