Adecuación del tratamiento de la faringoamigdalitis aguda a la evidencia científica

Sangrador, Carlos Ochoa; Fernández, M. Vilela; Baelo, M. Cueto; Bouza, J.M.a Eiros; Galiana, L Inglada

doi:10.1016/s1695-4033(03)78145-4

Cited by 17 publications

(3 citation statements)

References 44 publications

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“…In some regions of the world, streptococcal resistance to antibiotics such as macrolides, clindamycin, and lincosamide has become an increasing concern [ 30 , 31 ]. In other studies carried out in Spain, the use of antibiotics other than penicillin V, have ranked first in pharyngitis, with amoxicillin being the leading antibiotic used, as in our study [ 32 , 33 ]. However, in an older study, amoxicillin and clavulanate was the preferred antibiotic by Spanish GPs [ 34 ].…”

Section: Discussionsupporting

confidence: 71%

Survey of Spanish general practitioners’ attitudes toward management of sore throat: an internet-based questionnaire study

Llor¹,

Vilaseca

Lehrer

et al. 2017

BMC Fam Pract

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BackgroundThe management of sore throat varies widely in Europe. The objective of this study was to gain insight into clinicians’ perceptions on the current management of sore throat in Spain.MethodsCross-sectional, internet-based questionnaire study answered from July to September 2013. General practitioners (GPs) affiliated with the two largest scientific societies of primary care were invited to participate in the study. Questions were asked about physician knowledge, the use of current national guidelines for sore throat management, and management in two clinical scenarios, depicting a young adult with sore throat and: 1. cough, coriza with or without fever, and 2. fever without cough and coriza.ResultsThe questionnaire was completed by 1476 GPs (5%) and 12.7% declared using rapid antigen detection tests. Antibiotics were considered by 18.8% of the GPs in the first scenario and by 32% in the second scenario (p < 0.001). The antibiotics most commonly mentioned by GPs were amoxicillin and amoxicillin + clavulanate (52.7 and 31.2%, respectively) whereas penicillin V was only prescribed in 11.9% of the cases. The drugs most commonly considered in both scenarios were analgesics and anti-inflammatory drugs. Antitussives, decongestants and expectorants were more commonly prescribed in cases of suspected viral infection (p < 0.001).ConclusionsGPs have misconceptions as to the indications for using rapid antigen detection tests and prescribing drugs in the management of sore throat. These results suggest that guidelines are seldom followed since one in five GPs declared giving antibiotics for patients with a suspected viral infection and the use of second-choice antibiotics seems considerable.

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Section: Discussionsupporting

confidence: 71%

Survey of Spanish general practitioners’ attitudes toward management of sore throat: an internet-based questionnaire study

Llor¹,

Vilaseca

Lehrer

et al. 2017

BMC Fam Pract

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show abstract

“…GABHS is the only common form of AP for which antibiotic therapy is indicated [2,5], but according to Spanish studies, a total of 80-90% of Spanish children with AP are being treated with antibiotics [4,26]. The justification for treating GABHS pharyngitis among children is primarily based on trying to avoid the complications associated with GABHS, including rheumatic fever and suppurative complications [15,29].…”

Section: Introductionmentioning

confidence: 99%

“…The use of a clinical scoring system based on clinical history and physical examination only, to triage the diagnosis, is a common practice in Spain [10,26]. It saves testing costs but it has a low diagnostic specificity for streptococcal pharyngitis, which results in overdiagnosis with unnecessary prescribing of antimicrobial drugs [22,32].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and management of acute pharyngitis in a paediatric population: a cost–effectiveness analysis

et al. 2011

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Acute pharyngitis is one of the most frequent causes of primary care physician visits; however, there is no agreement about which is the best strategy to diagnose and manage acute pharyngitis in children. The aim of the current study was to evaluate the cost-effectiveness of the recommended strategies to diagnose and manage acute pharyngitis in a paediatric population. A decision tree analysis was performed to compare the following six strategies: "treat all", "clinical scoring", "rapid test", "culture", "rapid test + culture" and "clinical scoring + rapid test". The cost data came from the Spanish National Health Service sources. Cost-effectiveness was calculated from the payer's perspective. Effectiveness was measured as the proportion of patients cured without complications from the disease and did not have any reaction to penicillin therapy; a sensitivity analysis was performed. The findings revealed that the "clinical scoring + rapid test" strategy is the most cost-effective, with a cost-effectiveness ratio of 50.72 . This strategy dominated all others except "culture", which was the most effective but also the most costly. The sensitivity analysis showed that "rapid test" became the most cost-effective strategy when the clinical scoring sensitivity was <91% and its specificity was ≤9%. In conclusion, the use of a clinical scoring system to triage the diagnoses and performing a rapid antigen test for those with a high score is the most cost-effective strategy for the diagnosis and management of acute pharyngitis in children. When the clinical scoring system has a low diagnostic accuracy, testing all patients with rapid test becomes the most cost-effective strategy.

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La prescripción farmacéutica en Atención Primaria. Mucho más que un problema de gasto

Sanfélix‐Gimeno¹,

Peiró²,

Meneu³

2011

La Refundación De La Atención Primaria

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Adecuación del tratamiento de la faringoamigdalitis aguda a la evidencia científica

Cited by 17 publications

References 44 publications

Survey of Spanish general practitioners’ attitudes toward management of sore throat: an internet-based questionnaire study

Survey of Spanish general practitioners’ attitudes toward management of sore throat: an internet-based questionnaire study

Diagnosis and management of acute pharyngitis in a paediatric population: a cost–effectiveness analysis

La prescripción farmacéutica en Atención Primaria. Mucho más que un problema de gasto

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