Knowledge, Attitude, and Practice of House Officers to the Diagnosis and Management of Bacterial Pharyngitis: A Multicenter Cross-Sectional Study.

Abstract

Pharyngitis is one of the most common clinical presentations in pediatric clinics. Streptococcal pharyngitis reaches a nadir in the early school years, and it is vital to diagnose it earlyto avoid the serious complications that can arise from improper treatment, such as acute rheumatic fever and rheumatic heart disease. This is a cross-sectional multicenter study of medical house officers conducted from January to February 2018. This study surveyed 135 house officers at Khartoum's primary health centers and hospitals. Most of the respondents were males (76/135;56%). Most of the house officers reported seeing patients with throat complaints 1-2 times per week (58/135; 43%). The most common complication was acute rheumatic fever (65/135; 48%). Out of all the criteria of a Group A beta-hemolytic streptococcus (GAS) pharyngitis diagnosis, absence of cough and tender lymph nodes were the least recognized by house officers, i.e. 11.9%(16/135) and 45.2% (61/135), respectively. Only (4/135) 3% knew the full criteria for diagnosing bacterial pharyngitis. Throat culture was the most commonly used lab test to diagnose bacterial pharyngitis (115/135; 85.2%). The majority of participants did not recognize an IM injection of benzathine penicillin G as the first-line management of bacterial pharyngitis (101/135; 74.8%). The participants had moderate knowledge (93/135; 68.9%). Those with poor knowledge also happened to have poor practice (p = 0.009). Those who see more cases per week were also more likely to have good knowledge (p = 0.000). House officers with a moderate attitude constituted about 48.9%(66/135) of the whole sample. The most often prescribed medication was amoxicillin-clavulanic acid for one week (53/135; 39.3%). The practice score was associated with a lower knowledge (p = 0.009). Only 20.7%(28/135) of the participants in our study were adherent to the use of benzathine penicillin G as the first-line management of bacterial pharyngitis. House officers had poor-to-moderate knowledge regarding the diagnosis and management of bacterial pharyngitis, especially in regardto what antibiotic to use. However, their fear of antibiotic resistance was a good behavior.