Physicians management of sore throat in children in Benin City, Nigeria

Abstract

Sorethroat is a common reason for presentation in primary paediatric care. Because only minority of cases of pharyngitis is caused by bacteria, physicians have been guided by various recommendations on the judicious use of antibiotics to avoid overprescription. In the absence of guidelines, the treatment approaches between physicians may differ. The management of children with sorethroat by physicians inBeninCity,Mid-WesternNigeriawas evaluated. The experience and practice of 25 paediatricians and 30 non paediatricians who routinely attend to children with sorethroat in Benin metropolis, Nigeria were evaluated with the aid of a self administered questionnaire. Information sought for included biodata, empirical antibiotic prescription. The choice of antibiotic and complications of pharyngitis encountered in practice. Majority of respondents 31(56.4 %) considered viruses as the commonest cause of pharyngitis. Despite this an equal proportion 31(56.4 %) treated children with sorethroat empirically with antibiotics. Of these, significantly more paediatricians 19(61.3%) than non paediatricians 12(38.7%) considered viruses the commonest cause of pharyngitis, P = 0.013. CI (0.10 0.63). Almost three quarter (72.7 %) of respondents examine the throat of the childrenwhile only 18.2%obtained throat swab formicrobiological analysis. The 24 doctorswho did not treat empiricallywould prescribe antibiotic if the patient has purulent pharyngeal exudates, fever and adenitis.Augmentin and cefuroximewere themost prescribed antibiotics. Alot of children served by these doctors receive antibiotic needlessly from empirical antibiotic treatment of pharyngitis.National guidelines on appropriate antibiotic use is needed to promote rational use of antibiotics and reduce antibiotic overuse.

Keywords: Sore throat, streptococcal, antibiotic, physicians,Benin