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Published in: European Journal of Clinical Microbiology & Infectious Diseases 6/2020

01-06-2020 | Pharyngitis | Original Article

Pediatrician’s approach to diagnosis and management of group A streptococcal pharyngitis

Authors: Ilenia Di Muzio, Debora Mariarita d’Angelo, Caterina Di Battista, Giuseppe Lapergola, Ilaria Zenobi, Valentina Marzetti, Luciana Breda, Emma Altobelli

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 6/2020

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Abstract

Group A streptococcal (GAS) pharyngitis is responsible for 20–30% of pharyngitis cases in children (Shulman et al. Clin Infect Dis 55(10):e86–e102, 2012). Recommendations for the diagnosis and treatment of GAS pharyngitis have been published by the Italian National Institute of Health guidelines in 2012 (ESCMID Sore Throat Guideline Group et al. Clin Microbiol Infect 18(Suppl 1):1–28, 2012). Adherence to such guidance is relevant for primary prevention of complications of GAS pharyngitis, above all rheumatic fever (RF). The aim of our study was to evaluate the application of Italian guidelines by the family pediatricians from the Abruzzo region. A validated questionnaire was completed by the family pediatricians and used for data collection. The 154 family pediatricians from Abruzzo (88% of the total number of family pediatricians) participated in the study. Out of the 1232 answers, 455 (37%) were wrong. Only 8% of the participants answered correctly all the questions, whereas 0.6% missed all the questions. Through the Spearman’s correlation, our study found an inverse significant correlation between the questions regarding primary prophylaxis (Score B) and the work experience of pediatricians (Rho = − 0.276, p = 0.048). The majority of the family pediatricians from the Abruzzo region, in line with studies from other countries, have significant knowledge gaps about the diagnosis and treatment of GAS pharyngitis. Therefore, strategies to increase the pediatricians’ awareness of the guidelines are needed, in order to reduce the RF incidence.
Literature
1.
go back to reference Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C (2012) Clinical practice guideline for the diagnosis and Management of Group a Streptococcal Pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis 55(10):e86–e102CrossRef Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C (2012) Clinical practice guideline for the diagnosis and Management of Group a Streptococcal Pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis 55(10):e86–e102CrossRef
2.
go back to reference ESCMID Sore Throat Guideline Group, Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, Verheij T. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012 Apr;18 Suppl 1:1–28 ESCMID Sore Throat Guideline Group, Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, Verheij T. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012 Apr;18 Suppl 1:1–28
3.
go back to reference Chiappini E, Principi N, Mansi N et al (2012) Italian panel management of acute pharyngitis in children: summary of the Italian National Institute of health guidelines. Clin Ther 34:1442–1458CrossRef Chiappini E, Principi N, Mansi N et al (2012) Italian panel management of acute pharyngitis in children: summary of the Italian National Institute of health guidelines. Clin Ther 34:1442–1458CrossRef
4.
go back to reference Breda L, Marzetti V, Gaspari S, Del Torto M, Chiarelli F, Altobelli E (2012) Population-based study of incidence and clinical characteristics of rheumatic fever in Abruzzo, Central Italy, 2000-2009. J Pediatr 160:832–836CrossRef Breda L, Marzetti V, Gaspari S, Del Torto M, Chiarelli F, Altobelli E (2012) Population-based study of incidence and clinical characteristics of rheumatic fever in Abruzzo, Central Italy, 2000-2009. J Pediatr 160:832–836CrossRef
5.
go back to reference Pastore S, De Cunto A, Benettoni A, Berton E, Taddio A, Lepore L (2011) The resurgence of rheumatic fever in a developed country area: the role of echocardiography. Rheumatology 50:396–400CrossRef Pastore S, De Cunto A, Benettoni A, Berton E, Taddio A, Lepore L (2011) The resurgence of rheumatic fever in a developed country area: the role of echocardiography. Rheumatology 50:396–400CrossRef
6.
go back to reference Hedin K, Strandberg EL, Gröndal H, Brorsson A, Thulesius H, André M (2014 Dec) Management of patients with sore throats in relation to guidelines: an interview study in Sweden. Scand J Prim Health Care 32(4):193–199CrossRef Hedin K, Strandberg EL, Gröndal H, Brorsson A, Thulesius H, André M (2014 Dec) Management of patients with sore throats in relation to guidelines: an interview study in Sweden. Scand J Prim Health Care 32(4):193–199CrossRef
7.
go back to reference Alkhazi AA, Alessa KM, Almutairi AM, Almadi HA, Akkam A, Almutairi MK, Alhamad OA, Ghazal HS (2018 Nov 16) Improving pediatric emergency department physicians' adherence to clinical practice guidelines on the diagnosis and management of group a betahemolytic streptococcal pharyngitis-a cross-sectional study. Int J Emerg Med 11:49CrossRef Alkhazi AA, Alessa KM, Almutairi AM, Almadi HA, Akkam A, Almutairi MK, Alhamad OA, Ghazal HS (2018 Nov 16) Improving pediatric emergency department physicians' adherence to clinical practice guidelines on the diagnosis and management of group a betahemolytic streptococcal pharyngitis-a cross-sectional study. Int J Emerg Med 11:49CrossRef
8.
go back to reference Brennan-Krohn T, Ozonoff A, Sandora TJ (2018 Feb 9) Adherence to guidelines for testing and treatment of children with pharyngitis: a retrospective study. BMC Pediatr 18(1):43CrossRef Brennan-Krohn T, Ozonoff A, Sandora TJ (2018 Feb 9) Adherence to guidelines for testing and treatment of children with pharyngitis: a retrospective study. BMC Pediatr 18(1):43CrossRef
9.
go back to reference Norton LE, Lee BR, Harte L, Mann K, Newland JG, Grimes RA, Myers AL. Improving guideline-based streptococcal pharyngitis testing: a quality improvement initiative. Pediatrics. 2018 Jul;142(1). pii: e20172033 Norton LE, Lee BR, Harte L, Mann K, Newland JG, Grimes RA, Myers AL. Improving guideline-based streptococcal pharyngitis testing: a quality improvement initiative. Pediatrics. 2018 Jul;142(1). pii: e20172033
10.
go back to reference Milne RJ, Lennon DR, Stewart JM, Vander Hoorn S, Scuffham PA (2012) Incidence of acute rheumatic fever in New Zealand children and youth. J Paediatr Child Health 48:685–691CrossRef Milne RJ, Lennon DR, Stewart JM, Vander Hoorn S, Scuffham PA (2012) Incidence of acute rheumatic fever in New Zealand children and youth. J Paediatr Child Health 48:685–691CrossRef
11.
go back to reference Lawrence JG, Carapetis JR, Griffiths K, Edwards K, Condon JR (2013) Acute rheumatic fever and rheumatic heart disease: incidence and progression in the Northern Territory of Australia, 1997 to 2010. Circulation 128:492–501CrossRef Lawrence JG, Carapetis JR, Griffiths K, Edwards K, Condon JR (2013) Acute rheumatic fever and rheumatic heart disease: incidence and progression in the Northern Territory of Australia, 1997 to 2010. Circulation 128:492–501CrossRef
12.
go back to reference Karthikeyan G, Guilherme L (2018) Acute rheumatic fever. Lancet 392:161–174CrossRef Karthikeyan G, Guilherme L (2018) Acute rheumatic fever. Lancet 392:161–174CrossRef
Metadata
Title
Pediatrician’s approach to diagnosis and management of group A streptococcal pharyngitis
Authors
Ilenia Di Muzio
Debora Mariarita d’Angelo
Caterina Di Battista
Giuseppe Lapergola
Ilaria Zenobi
Valentina Marzetti
Luciana Breda
Emma Altobelli
Publication date
01-06-2020
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 6/2020
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-020-03821-y

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