Primary Healthcare Center Hostalric, Institut d'Assistència Sanitària de Girona, Breda-Hostalric, Spain.
BMC Fam Pract. 2010 Mar 23;11:25. doi: 10.1186/1471-2296-11-25.
Acute pharyngitis is one of the most frequent consultations to the general practitioner and in most of the cases an antibiotic is prescribed in primary care in Spain. Bacterial etiology, mainly by group A beta-hemolytic streptococcus (GABHS), accounts for 10-20% of all these infections in adults. The purpose of this study is to assess the impact of rapid antigen detection testing (RADT) to identify GABHS in acute pharyngitis on the utilization of antibiotics in primary care.
METHODS/DESIGN: Multicentric randomized controlled trial in which antibiotic prescription between two groups of patients with acute pharyngitis will be compared. The trial will include two arms, a control and an intervention group in which RADT will be performed. The primary outcome measure will be the proportion of inappropriate antibiotic prescription in each group. Two hundred seventy-six patients are required to detect a reduction in antibiotic prescription from 85% in the control group to 75% in the intervention group with a power of 90% and a level of significance of 5%. Secondary outcome measures will be specific antibiotic treatment, antibiotic resistance rates, secondary effects, days without working, medical visits during the first month and patient satisfaction.
The implementation of RADT would allow a more rational use of antibiotics and would prevent adverse effects of antibiotics, emergence of antibiotic resistance and the growth of inefficient health expenses.
急性咽炎是全科医生最常接诊的病症之一，在西班牙，大多数情况下，抗生素会被开给这些患者。细菌性病因，主要是 A 组乙型溶血性链球菌（GABHS），占成人所有此类感染的 10-20%。本研究旨在评估快速抗原检测试验（RADT）用于鉴定急性咽炎中的 GABHS 对初级保健中抗生素使用的影响。
方法/设计：这是一项多中心随机对照试验，将比较两组急性咽炎患者的抗生素处方。试验将包括两个组，一个对照组和一个干预组，其中将进行 RADT。主要结局指标是每组不适当抗生素处方的比例。需要 276 名患者来检测从对照组的 85%减少到干预组的 75%，这一减少的效果有 90%的把握度和 5%的显著性水平。次要结局指标将是特定的抗生素治疗、抗生素耐药率、副作用、缺勤天数、第一个月的就诊次数和患者满意度。
RADT 的实施将允许更合理地使用抗生素，并防止抗生素的不良反应、抗生素耐药性的出现和低效卫生费用的增长。
