Abstract

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.

Highlights

  • The management of sore throat varies widely in Europe

  • In a recent paper carried out in Spain, we observed that if general practitioner (GP) had appropriately used rapid antigen detection tests and had strictly followed current guidelines, 84.5% of the antibiotics prescribed for pharyngitis would have been saved [9]

  • Rapid antigen detection tests were declared to be used in 12.7% of the cases of sore throat

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Summary

Introduction

The objective of this study was to gain insight into clinicians’ perceptions on the current management of sore throat in Spain. Local guidelines recommend the prescription of penicillin V for suspected GAS pharyngitis in patients otherwise not allergic to βlactams [4], since it is a well-tolerated, inexpensive, narrow-spectrum antibiotic for which isolates of penicillin-resistant GAS have not yet been described, despite having been used for more 70 years. This is apparently because these microorganisms are intolerant to mutations that reduce the affinity of penicillin-binding proteins [13]

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