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Tratamiento con antibióticos de niños con dolor de garganta
Jeffrey A Linder1, David W Bates, Grace M Lee
1Division of General Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA. jlinder@partners.org
JAMA
|November 10, 2005
Resumen
La prescripción de antibióticos para niños con dolor de garganta sigue siendo alta, excediendo la prevalencia de estreptococos beta-hemolíticos del grupo A (GABHS). Si bien las pruebas de GABHS pueden reducir el uso de antibióticos en casos específicos, se subutiliza en la atención pediátrica.
Área de la Ciencia:
- La pediatría es la medicina de los niños.
- Enfermedades infecciosas Enfermedades infecciosas.
- Directrices para la práctica clínica.
Sus antecedentes:
- Los estreptococos beta-hemolíticos del grupo A (GABHS) causan entre el 15 y el 36 por ciento de los dolores de garganta pediátricos.
- La prueba de GABHS antes de la prescripción de antibióticos se recomienda para niños con dolor de garganta.
- Los antibióticos recomendados para GABHS incluyen penicilina, amoxicilina, eritromicina y cefalosporinas de primera generación.
Objetivo del estudio:
- Para medir las tasas de prescripción de antibióticos y pruebas de GABHS en niños con dolor de garganta.
- Evaluar la asociación entre las pruebas de GABHS y las decisiones de tratamiento con antibióticos.
Principales métodos:
- Análisis de los datos de la Encuesta Nacional de Atención Médica Ambulatoria y de la Encuesta Nacional de Atención Médica Ambulatoria de los Hospitales (1995-2003).
- Incluidas las visitas de niños de 3 a 17 años con dolor de garganta.
- Se examinaron las tasas nacionales de prescripción de antibióticos, uso de antibióticos recomendado / no recomendado y pruebas de GABHS.
Principales resultados:
- Los antibióticos se prescribieron en el 53% de los 7,3 millones de visitas anuales de dolor de garganta.
- Los antibióticos no recomendados se administraron al 27% de los niños que recibieron antibióticos.
- La prueba de GABHS se realizó en el 53% de las visitas y se asoció con una menor prescripción de antibióticos para diagnósticos específicos (faringitis, amigdalitis, dolor de garganta estreptocócico).
Conclusiones:
- La prescripción de antibióticos para el dolor de garganta pediátrico excede la prevalencia esperada de GABHS.
- Una disminución en la prescripción de antibióticos desde 1995-2003 se debió a la reducción en el uso de los agentes recomendados.
- La prueba GABHS está subutilizada a pesar de su asociación con la reducción de la prescripción de antibióticos en ciertos casos pediátricos.
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