Abi Rizk Grace, Nasr Hage Claudine, El Osta Lana
Family Medicine Department, Hôtel-Dieu de France University Hospital, Beirut.
J Med Liban. 2010 Oct-Dec;58(4):217-21.
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).
A questionnaire was completed by 103 PHC physicians randomly selected and working in Beirut, Lebanon.
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.
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.
研究表明，尽管有临床证据和国际指南，但抗生素在治疗咽炎时的处方往往并不恰当。本研究调查了初级保健医生（PHC）使用抗生素的情况，以及他们在决定是否按照美国疾病控制与预防中心（CDC）的建议进行咽喉培养和开具抗生素处方时对临床因素的依赖程度。
对随机抽取的103名在黎巴嫩贝鲁特工作的初级保健医生进行问卷调查。
初级保健医生给42%的咽炎患者开了抗生素，尤其是在冬季就诊的患者（68%对比38%；p<0.01）。导致咽炎患者使用抗生素和进行咽喉培养的最常见症状和体征是扁桃体渗出、颈部淋巴结肿大和发热。没有医生在决定是否开具抗生素或进行咽喉培养时采用疾病预防控制中心评分中的所有标准。
本研究表明，初级保健医生在咽炎治疗中抗生素处方率较高，且未遵循临床指南。应通过传播国际建议和监测实践来帮助医生改进其治疗方法。
