Pajot Marie, Asseray Nathalie, Leux Christophe, Senand Rémy, Garnier François, Potel Gilles, Lombrail Pierre, Ballereau Françoise
MedQual, Centre d'information et de ressources pour le bon usage des produits de santé, CHU de Nantes, F-44093 Nantes Cedex 01, France.
Presse Med. 2010 Apr;39(4):e77-85. doi: 10.1016/j.lpm.2009.06.018. Epub 2009 Sep 24.
The use of the rapid diagnostic test (RDT) and the strategy of management of pharyngitis in medical practice are little known.
During the 2006-2007 winter, a survey was conducted in the Pays de la Loire Region to evaluate the use of the RDT. A focus group was also organised.
Data were collected from 525 patients (patients who were consulting for a sore throat, angina or patients for whom a RDT was made). RDT were performed on 245 patients (46%). The sixty positive RDT patients systematically received an antibiotic. Twenty negative RDT patients received an antibiotic. More than 75% of GPs considered the RDT useful or very useful.
The guidelines for the management of pharyngitis are known but they are partially followed by physicians. Many countries have national guidelines for the management of tonsillitis and they are also not unanimous. When patients had pharyngitis symptoms, the frequency of antibiotic prescription was lower when the RDT was used as recommended by the French Medicines Agency (AFSSAPS). The treatment must be short in order to improve the compliance of outpatients and reduce the inappropriate use of antibiotics.
A decrease in antibiotics prescription was recorded in the community. It was attributed to the availability of the RDT provided by the CNAMTS (French National Health Service). Moreover, the RDT are still free for practitioners and their reimbursement could be extended to hospital.
快速诊断检测(RDT)在医学实践中的使用以及咽炎的管理策略鲜为人知。
在2006 - 2007年冬季,在卢瓦尔河地区进行了一项调查以评估RDT的使用情况。还组织了一个焦点小组。
收集了525名患者的数据(因喉咙痛、咽痛就诊的患者或接受RDT检测的患者)。对245名患者(46%)进行了RDT检测。60名RDT检测呈阳性的患者系统性地接受了抗生素治疗。20名RDT检测呈阴性的患者接受了抗生素治疗。超过75%的全科医生认为RDT有用或非常有用。
咽炎管理指南是已知的,但医生们只是部分遵循。许多国家有扁桃体炎管理的国家指南,而且也不一致。当患者出现咽炎症状时,按照法国药品安全局(AFSSAPS)的建议使用RDT时,抗生素处方的频率较低。治疗必须简短,以提高门诊患者的依从性并减少抗生素的不当使用。
社区中抗生素处方量有所下降。这归因于法国国家健康保险基金管理局(CNAMTS)提供的RDT检测。此外,RDT检测对从业者仍然免费,其报销范围可扩大到医院。