Sadoh W E, Akinsete A M
Department of Child Health, University of Benin/ University of Benin Teaching Hospital, Benin City, Nigeria.
Niger J Clin Pract. 2009 Dec;12(4):407-11.
Sorethroat is a common reason for presentation in primary paediatric care. Because only a minority of cases of pharyngitis is caused by bacteria, physicians have been guided by various recommendations on the judicious use of antibiotics to avoid overprescription. In the absence of guidelines, the treatment approaches between physicians may differ. The management of children with sorethroat by physicians in Benin City, Mid-Western Nigeria was evaluated.
The experience and practice of 25 paediatricians and 30 non paediatricians who routinely attend to children with sorethroat in Benin metropolis, Nigeria were evaluated with the aid of a self administered questionnaire. Information sought for included biodata, empirical antibiotic prescription. The choice of antibiotic and complications ofpharyngitis encountered in practice.
Majority of respondents 31(56.4 %) considered viruses as the commonest cause of pharyngitis. Despite this an equal proportion 31(56.4 %) treated children with sorethroat empirically with antibiotics. Of these, significantly more paediatricians 19(61.3 %) than non paediatricians 12(38.7 %) considered viruses the commonest cause of pharyngitis, P = 0.013. CI (0.10 0.63). Almost three quarter (72.7 %) of respondents examine the throat of the children while only 18.2 % obtained throat swab for microbiological analysis. The 24 doctors who did not treat empirically would prescribe antibiotic if the patient has purulent pharyngeal exudates, fever and adenitis. Augmentin and cefuroxime were the most prescribed antibiotics.
A lot of children served by these doctors receive antibiotic needlessly from empirical antibiotic treatment ofpharyngitis. National guidelines on appropriate antibiotic use is needed to promote rational use of antibiotics and reduce antibiotic overuse.
喉咙痛是小儿初级保健中常见的就诊原因。由于只有少数咽炎病例是由细菌引起的，医生们一直遵循各种关于合理使用抗生素以避免过度开药的建议。在缺乏指南的情况下，医生之间的治疗方法可能会有所不同。对尼日利亚中西部贝宁城的医生治疗喉咙痛儿童的情况进行了评估。
借助一份自填式问卷，对尼日利亚贝宁大都市中25名儿科医生和30名非儿科医生治疗喉咙痛儿童的经验和做法进行了评估。所寻求的信息包括生物数据、经验性抗生素处方、抗生素的选择以及实际中遇到的咽炎并发症。
大多数受访者31名（56.4%）认为病毒是咽炎最常见的病因。尽管如此，同样比例的31名（56.4%）受访者对喉咙痛儿童进行了经验性抗生素治疗。其中，认为病毒是咽炎最常见病因的儿科医生19名（61.3%）明显多于非儿科医生12名（38.7%），P = 0.013，置信区间（0.10 0.63）。近四分之三（72.7%）的受访者检查了儿童的喉咙，而只有18.2%的人采集了咽拭子进行微生物分析。24名未进行经验性治疗的医生会在患者有脓性咽部渗出物、发热和腺炎时开具抗生素。阿莫西林克拉维酸和头孢呋辛是最常开具的抗生素。
这些医生诊治的许多儿童因咽炎的经验性抗生素治疗而不必要地接受了抗生素。需要国家关于适当使用抗生素的指南，以促进抗生素的合理使用并减少抗生素的过度使用。
