Misbah Zaheer, Humaira Zafar, Abbas Hayat, Kausar Izhar, Mobina Dhodhy.
Antibiotic prescribing patterns for sore throat infections in a university-based tertiary care centre.
J Rawal Med Coll Jan ;9(1):30-2.

Background: To establish the pattern of presentation and management of sore throat and to gather information on whether throat cultures have changed in relation to age, gender, clinical presentation and laboratory test results. The clinical diagnosis was also compared with the medicine prescribed. Methods: The study was conducted in the Department of Pathology, Rawalpindi General Hospital. Data was collected on 100 patients visiting ENT out-patient department of the hospital with main complaints of sore throat regardless of sex, age nationality, marital status, occupation, or location of residence. They were prescribed antibiotics that were available in the hospital. A throat swab was taken gently without touching the teeth, tongue or gums. It was then immediately transported to Microbiology Department of the hospital. Throat swabs were wiped across the blood agar plates and chocolate agar plates, incubated for 24-48 hours to allow the growth of bacteria. The results were available in 2-3 days. Results: Of the one hundred patients, (38%) males and {62%1} females presenting with sore throat, majority were less than 35 years old. The most frequent symptom was pain and difficulty in swallowing {71%} followed by dry throat (52%), headache (22%), dry cough {15%} and feeling of weakness (8%). The most frequent sign was fever {76%}, cough (82%), enlarged cervical lymph nodes {58%) and exudative tonsillitis {34%}. The patients were most frequently diagnosed as having pharyngitis {56%}, than tonsillitis {32%). The least determined finding was laryngitis (12%). The most frequently prescribed antibiotics were penicillins {48%), flouroquinolones (28%) and macrolides {16%}. These groups of antibiotics constituted {92%) of antibiotics prescribed for URTIs. Of the culture swabs taken, 68% were found to be positive. Only 8% had GABHS isolated. Conclusion: Group A B-hemolytic streptococci are found only in a small number of patients presenting with sore throat. Injudicious antibiotic prescribing is rather high and should be reduced to modest levels. Doctors should be educated and public campaigns mounted to increase awareness of the existence and importance of bacterial resistance.

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