(34) Evaluating The Effectiveness of Implementing Diagnostic Stewardship in The Management of Acute Pharyngitis: Insights from India

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 365

Presenting Author(s)

Aleena Issac, Pharm D
– Clinical Quality Auditor & Medication Therapy Management Trainee , Mary Queen's Mission Hospital, Kanjirapally, Kerala, India

Co-Author(s)

Jose J. Kochuparambil
– Mary Queens Mission Hospital, Kanjirappally, India, Pala, Kerala, India
Jais Vayalikunnel
– Mary Queens Mission Hospital, India

Background: Acute pharyngitis, a non-serious illness with either viral or bacterial cause, is often under-studied in the Indian state of Kerala.

Objectives: To evaluate the Diagnostic stewardship adherence in the management of Acute Pharyngitis presented in the medical ward of a secondary care hospital in Kerala.

Methods: This retrospective study from March 2019 to April 2021 was conducted on all the patients presented in the medical ward with a diagnosis of Acute Pharyngitis. The data was collected from the electronic medical database and details regarding demographics, symptoms, length of stay, objective diagnostic methods, statements about differential diagnosis, management of infection, etc were collected. Descriptive statistics and Chi-square analysis were done using SPSS version 20 with CI 95%.

Results: A total of 235 patients presented with acute pharyngitis as the prime complaint were studied and in this, 103 (43.82%) were males and the mean age of the group was 43.71 ± 12.7. The majority of patients were managed in the outpatient setting (83.2%) and the mean length of stay of the admitted patients was found to be 4 ± 0.56. On analyzing the complaints, 61% of patients had a sore throat, 38% had pain in swallowing and 20% with a hoarse voice were found as subjective evidence. None of the records depicts evidence of Modified Centor score and most of the statements regarding the differential diagnosis were unclear. Prescription pattern analysis regarding the management revealed that 95% of cases were prescribed with antibiotics and penicillins being the most commonly used with an average duration of therapy as 7 days. Supportive therapies were advised in 92% of cases and only 8.15% (20) of patients revisited for review within a month. No statistically significant correlation was noted between age group and sex with an antibiotic prescription.

Conclusions: Poor adherence to diagnostic stewardship protocols can lead to indiscriminate antibiotic use and thereby promoting antibiotic resistance.