Determinants of antibiotic use and throat culture in managing pharyngitis among primary health care physicians in Beirut.

BACKGROUND

Studies have suggested that antibiotics are often inappropriately prescribed for the treatment of pharyngitis despite clinical evidence and international guidelines. This study examined the use of antibiotics by primary health care physicians (PHC) and their reliance on clinical factors in the decision to prescribe throat culture and antibiotics, as advocated by the Centers for Disease Control and Prevention (CDC).

METHODS

A questionnaire was completed by 103 PHC physicians randomly selected and working in Beirut, Lebanon.

RESULTS

Primary care physicians prescribed antibiotics to 42% of patients with pharyngitis, especially if patients consulted during winter v/s summer (68% v/s 38% ; p < 0.01). The most frequent symptoms and signs leading to antibiotic prescription and to throat culture in pharyngitis were tonsillar exudates, cervical adenopathy and fever. No physician used all the criteria in the score adopted by the CDC to decide on the prescription of antibiotic or throat culture.

CONCLUSION

This study showed a high prescription rate of antibiotics and a lack of adherence to clinical guidelines by PHC physicians in the management of pharyngitis. Efforts to help physicians improve their practices should be implemented by the diffusion of international recommendations and the monitoring of practices.