TY - JOUR
T1 - Adherence to antibiotic guidelines in the treatment of acute pharyngeal infections
AU - Øhrstrøm, Mette Thrane
AU - Danstrup, Christian Sander
AU - Klug, Tejs Ehlers
N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
PY - 2019/2
Y1 - 2019/2
N2 - INTRODUCTION: We aimed to investigate doctors' ad-herence to the local antibiotic guidelines for treatment of patients admitted with acute pharyngeal infections and to identify patient-related risk factors for non-adherence.METHODS: All patients with acute tonsillitis, peritonsillar abscess (PTA), and parapharyngeal abscess admitted to the Ear-Nose-Throat Department, Aarhus University Hospital, in the 2001-2014 period were included in the study.RESULTS: In total, 2,567 patients were hospitalised with acute pharyngeal infection. In non-allergic patients, penicillin was prescribed to 81%, either alone (48%) or in combination with metronidazole (33%). Macrolides (54%) and cefuroxime (44%) were the drugs of choice in 85 (98%) patients who were allergic to penicillin. Patients were prescribed antibiotics according to guidelines in 63% of cases. The addition of metronidazole to penicillin was the main (75% of cases) reason for non-adherence. Increasing patient age and male gender were independent risk factors for non-adherence. PTA patients treated according to the guidelines had a significantly shorter hospital stay than patients treated with additional metronidazole or broad-spectrum antibiotics.CONCLUSIONS: A significant (37%) proportion of patients with acute pharyngeal infections were treated non-adherently to antibiotic guidelines, mainly because of (inappropriate) addition of metronidazole to penicillin.FUNDING: This work was supported by the Lundbeck Foundation (Grant number R185-2014-2482).TRIAL REGISTRATION: The study was approved by the Danish Data Protection Agency.
AB - INTRODUCTION: We aimed to investigate doctors' ad-herence to the local antibiotic guidelines for treatment of patients admitted with acute pharyngeal infections and to identify patient-related risk factors for non-adherence.METHODS: All patients with acute tonsillitis, peritonsillar abscess (PTA), and parapharyngeal abscess admitted to the Ear-Nose-Throat Department, Aarhus University Hospital, in the 2001-2014 period were included in the study.RESULTS: In total, 2,567 patients were hospitalised with acute pharyngeal infection. In non-allergic patients, penicillin was prescribed to 81%, either alone (48%) or in combination with metronidazole (33%). Macrolides (54%) and cefuroxime (44%) were the drugs of choice in 85 (98%) patients who were allergic to penicillin. Patients were prescribed antibiotics according to guidelines in 63% of cases. The addition of metronidazole to penicillin was the main (75% of cases) reason for non-adherence. Increasing patient age and male gender were independent risk factors for non-adherence. PTA patients treated according to the guidelines had a significantly shorter hospital stay than patients treated with additional metronidazole or broad-spectrum antibiotics.CONCLUSIONS: A significant (37%) proportion of patients with acute pharyngeal infections were treated non-adherently to antibiotic guidelines, mainly because of (inappropriate) addition of metronidazole to penicillin.FUNDING: This work was supported by the Lundbeck Foundation (Grant number R185-2014-2482).TRIAL REGISTRATION: The study was approved by the Danish Data Protection Agency.
KW - Acute Disease
KW - Adult
KW - Anti-Bacterial Agents/standards
KW - Denmark
KW - Drug Prescriptions/standards
KW - Female
KW - Guideline Adherence/statistics & numerical data
KW - Humans
KW - Male
KW - Metronidazole/standards
KW - Middle Aged
KW - Penicillins/standards
KW - Peritonsillar Abscess/drug therapy
KW - Pharyngeal Diseases/drug therapy
KW - Tonsillitis/drug therapy
M3 - Journal article
C2 - 30722825
SN - 1603-9629
VL - 66
JO - Danish Medical Journal
JF - Danish Medical Journal
IS - 2
M1 - A5530
ER -