A study on the drug prescribing pattern in acute, recurrent and chronic pharyngitis at a tertiary care hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20162459Abstract
Background: Pharyngitis, or sore throat, is often caused by infection. Common respiratory viruses account for the vast majority of cases, and these are usually self-limited. Bacteria are also important etiologic agents, and, when identified properly, may be treated with antibacterial, resulting in decreased local symptoms and prevention of serious sequelae. The objective of this study was to determine the drug prescribing pattern in acute, recurrent and chronic bacterial pharyngitis and to assess the efficacy and tolerability of AMAs.
Methods: 50 subjects of either gender were included in the study to assess the prescribing pattern in acute, recurrent and chronic pharyngitis by purposive sampling method.
Results: 94% subjects were between 16-45 years and mean age was 33.06±13.50. 96% were from lower middle and upper lower class. Presenting complaints were sore-throat with fever in all the subjects, Co-amoxiclav was the most commonly used antibiotic (48%) and others were cefpodoxime+clavulanic acid (36%), cefadroxil+clavulanic acid (8%), cefpodoxime (4%), cefuroxime (2%) and cefixime (2%). Concomitant medications used were NSAIDs and decongestants/mucolytic. The AMAs showed good tolerability with mild and self-limiting adverse effects which did not require discontinuation.
Conclusions: Acute, recurrent and chronic bacterial pharyngitis can be effectively treated by empirical use of various antimicrobials. Co-amoxiclav can be considered as the mainstay/primary option because of the proven efficacy, good tolerability and low cost.
References
Gerber MA. Group A streptococcus. In: Kliegman RM, Jenson HB, Behrman RE, Stanton BF, editors. Nelson Textbook of Pediatrics. 18th edition, New Delhi: Elsevier; 2008;2:1135-45.
Diagnosis and treatment of respiratory illness in children and adults. Institute for Clinical Systems Improvement. 2011;3:1-81. Available at https://www.icsi.org/_asset/1wp8x2/RespIllness.pdf.
Dhingra PL, Dhingra S. Acute and chronic pharyngitis. In: diseases of ear, nose and throat. 5th edition. New Delhi: Elsevier; 2010:268-270.
Somro A, Akram M, Khan MI, Asif HM, Sami A, Ali Shah SM, et al. Pharyngitis and sore throat: A review. African Journal of Biotechnology. 2011;10(33):6190-7.
Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: Update by the infectious diseases society of America. Clinical infectious diseases. 2012;55(10):86-102.
Struble K, Bronze MS, Halsey ES. Bacterial pharyngitis. Medscape reference; Available at http://emedicine.medscape.com/article/225243-overview. Accessed on 27 July 2013.
Ananthanarayan R, Paniker CKJ. Streptococcus. In: Textbook of Microbiology. 8th edition. Hyderabad: Universities Press (India) Private Limited; 2009:204-216.
Bisno AL, Gerber MA, Gwaltney JM, Kaplan EL, Schwartz RH. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clinical Infectious Diseases. 2002;35(2):113-25.
Choby BA. Diagnosis and treatment of streptococcal pharyngitis. American Family Physician. 2009;79(5):383-90.
Regoli M, Chiappini E, Bonsignori F, Galli L, de Martino M. Update on the management of acute pharyngitis in children. Italian Journal of Pediatrics. 2011;37:10.
Renner B, Mueller CA, Shephard A. Environmental and non-infectious factors in the aetiology of pharyngitis (sore throat). Inflammation Research. 2012;61(10):1041-52.
Cohen R. Clinical efficacy of cefpodoxime in respiratory tract infection. Journal of Antimicrobial Chemotherapy. 2002;50:23-7.
Hong SY, Taur Y, Jordan MR, Wanke C. Antimicrobial prescribing in the U.S. for adult acute pharyngitis in relation to treatment guidelines. J Eval Clin Pract Dec. 2011;17(6):1176-83.
Bisno AL. Are cephalosporins superior to penicillin for treatment of acute streptococcal pharyngitis? Clinical Infectious Diseases. 2004;38:1535-37.
Adam D, Scholz H, Helmerking M. Short-course antibiotic treatment of 4782 culture-proven cases of group A streptococcal tonsillopharyngitis and incidence of poststreptococcal sequelae. The Journal of Infectious Diseases. 2000;182:509-16.
