Carr N F, Wales S G, Young D
Department of Public Health and Community Medicine, University of Melbourne, Australia.
Br J Gen Pract. 1994 Nov;44(388):515-8.
Sore throat is one of the commonest presenting symptoms in general practice in Australia, and results in the prescription of an antibiotic in 50-90% of cases, despite the finding of bacterial throat infection in around 30% of cases or fewer.
This study set out to examine whether inaccurate knowledge about the pathophysiological features and management of sore throat helps to explain the high level of inappropriate antibiotic prescribing for sore throat by general practitioners.
A questionnaire with four case vignettes of sore throat presentations was sent to 400 randomly selected general practitioners, practising in Victoria, Australia. Of 367 eligible respondents, 284 responded (77%).
Of the respondents 97% reported that they would prescribe an antibiotic for the case of tonsillitis, 70% for the case of possible glandular fever, 29% for the child with probable viral sore throat and 9% for the adult with probable viral infection. There were no differences in prescribing rates between general practitioners of different sex, practice location, practice type or qualification. Overall, 25% of the antibiotics which formed the respondents' first choice were inappropriate broad-spectrum antibiotics.
General practitioners are generally accurate in their assessment of the features of sore throats, but less accurate in their knowledge of appropriate antibiotics.
喉咙痛是澳大利亚全科医疗中最常见的就诊症状之一，尽管在约30%或更少的病例中发现有细菌性咽喉感染，但在50 - 90%的病例中都会开具抗生素处方。
本研究旨在探讨对喉咙痛的病理生理特征及治疗方法的不准确认识，是否有助于解释全科医生对喉咙痛不恰当使用抗生素的高比例情况。
向随机抽取的400名在澳大利亚维多利亚州执业的全科医生发送了一份包含四个喉咙痛病例 vignette 的问卷。在367名符合条件的受访者中，284人回复（77%）。
在受访者中，97%表示会为扁桃体炎病例开具抗生素，70%会为可能是传染性单核细胞增多症的病例开具，29%会为可能是病毒性喉咙痛的儿童开具，9%会为可能是病毒感染的成人开具。不同性别、执业地点、执业类型或资质的全科医生在处方率上没有差异。总体而言，受访者首选的抗生素中有25%是不恰当的广谱抗生素。
全科医生对喉咙痛特征的评估总体上是准确的，但在合适抗生素的知识方面准确性较低。
