Department of Pediatrics, University of Chieti-Pescara, Chieti, Italy.
Department of Life, Health and Environmental Sciences, Epidemiology Unit, University of Aquila, L'Aquila, Italy.
Eur J Clin Microbiol Infect Dis. 2020 Jun;39(6):1103-1107. doi: 10.1007/s10096-020-03821-y. Epub 2020 Jan 27.
Group A streptococcal (GAS) pharyngitis is responsible for 20-30% of pharyngitis cases in children (Shulman et al. Clin Infect Dis 55(10):e86-e102, 2012). Recommendations for the diagnosis and treatment of GAS pharyngitis have been published by the Italian National Institute of Health guidelines in 2012 (ESCMID Sore Throat Guideline Group et al. Clin Microbiol Infect 18(Suppl 1):1-28, 2012). Adherence to such guidance is relevant for primary prevention of complications of GAS pharyngitis, above all rheumatic fever (RF). The aim of our study was to evaluate the application of Italian guidelines by the family pediatricians from the Abruzzo region. A validated questionnaire was completed by the family pediatricians and used for data collection. The 154 family pediatricians from Abruzzo (88% of the total number of family pediatricians) participated in the study. Out of the 1232 answers, 455 (37%) were wrong. Only 8% of the participants answered correctly all the questions, whereas 0.6% missed all the questions. Through the Spearman's correlation, our study found an inverse significant correlation between the questions regarding primary prophylaxis (Score B) and the work experience of pediatricians (Rho = - 0.276, p = 0.048). The majority of the family pediatricians from the Abruzzo region, in line with studies from other countries, have significant knowledge gaps about the diagnosis and treatment of GAS pharyngitis. Therefore, strategies to increase the pediatricians' awareness of the guidelines are needed, in order to reduce the RF incidence.
A 组链球菌（GAS）咽炎占儿童咽炎病例的 20-30%（Shulman 等人，Clin Infect Dis 55(10):e86-e102, 2012）。2012 年，意大利国家卫生研究院指南发布了 GAS 咽炎的诊断和治疗建议（ESCMID 咽痛指南组等，Clin Microbiol Infect 18(Suppl 1):1-28, 2012）。遵守这些指南对于预防 GAS 咽炎并发症（尤其是风湿热（RF））至关重要。我们的研究目的是评估阿布鲁佐地区家庭儿科医生对意大利指南的应用情况。家庭儿科医生填写了一份经过验证的问卷，用于数据收集。阿布鲁佐地区的 154 名家庭儿科医生（占家庭儿科医生总数的 88%）参与了这项研究。在 1232 个答案中，有 455 个（37%）是错误的。只有 8%的参与者正确回答了所有问题，而 0.6%的参与者错过了所有问题。通过斯皮尔曼相关性分析，我们的研究发现，初级预防问题（B 级评分）与儿科医生工作经验之间呈显著负相关（Rho=-0.276，p=0.048）。阿布鲁佐地区的大多数家庭儿科医生与其他国家的研究一样，在 GAS 咽炎的诊断和治疗方面存在显著的知识差距。因此，需要制定策略来提高儿科医生对指南的认识，以降低 RF 的发病率。
