Thesis
Rationale for Avoiding Indiscriminate Antibiotic Therapy in Treating Pharyngitis
Washington State University
Master of Nursing (MN), Washington State University
12/1998
Handle:
https://hdl.handle.net/2376/4004
Abstract
Pharyngitis is among the top three complaints of patients visiting their health care providers (HCP). Antibiotics are prescribed in as many as 80% of these sore throat visits. Studies have shown viruses to be the cause of up to 90% of pharyngitis. Research has shown no benefits of antibiotic therapy in treating viruses. It is easy to conclude that pharyngitis is over treated. The issues of treatment of pharyngitis are complex. Clinicians fear missing the diagnosis of Group A beta-hemolytic streptococcus (GABHS) and causing the patient an ensuing rheumatic condition. They also believe they can diagnose GABHS accurately by clinical signs and symptoms alone. Add to this the fears of causing other complications, and perhaps offending the patient by refusing the "expected" antibiotic prescription, and one can see why approximately half of all outpatient antibiotics used are for sore throat (pharyngitis). The most current literature demonstrates that acute rheumatic fever, caused by GABHS, is the only complication that can be prevented with surety by antibiotics, and that most patients with GABHS never seek the care of a HCP. More people in tIle United States die each year of drug reactions than complications of pharyngitis.\nProviders should be aware that studies have shown clinical signs and symptoms to be poorly sensitive in diagnosing GABHS. With bacterial resistance a constant threat, and ballooning costs of treating this largely self-limiting disease, antibiotic therapy should be restricted to treating only documented cases of GABHS. Rapid tests for GABHS are becoming more sensitive and specific, and traditional cultures provide answers in plenty of time to ward off complications. Patients should be taught not to expect antibiotics for sore throat, and to treat their sore throat symptomatically and rest for a day or two before running to the HCP. The time spent waiting may be well-spent, usually preventing unnecessary antimicrobial therapy, and when GABHS does tum up in the diagnosis, the wait gives the patient's immune system time to mount an attack, decreasing the likelihood of relapse.
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Details
- Title
- Rationale for Avoiding Indiscriminate Antibiotic Therapy in Treating Pharyngitis
- Creators
- Karen D. Walker
- Contributors
- Lorna Schumann (Advisor)
- Awarding Institution
- Washington State University
- Academic Unit
- Research Projects, College of Nursing
- Theses and Dissertations
- Master of Nursing (MN), Washington State University
- Publisher
- Washington State University; Spokane, Washington
- Identifiers
- 99900590727401842
- Copyright
- http://creativecommons.org/licenses/by-nc-sa/3.0/us; Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States (CC BY-NC-SA 3.0 US)
- Language
- English
- Resource Type
- Thesis