About 90 of patients with pharyngitis 100 of those with tonsillitis and 100 of

About 90 of patients with pharyngitis 100 of those

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About 90% of patients with pharyngitis, 100% of those with tonsillitis and 100% of those with pharyngotonsillitis received an antibiotic/s prescribed. World Health Organization recommends antibiotic therapy and analgesics for patients with tonsillitis or pharyngitis or both which could explain the high rate of antibiotic prescribing in these illnesses. They could be viral. For instance, acute pharyngitis is caused by Group A B – Hemolytic Streptococcus (GABHS) in only 5-15% of adults implying that the vast majority of adults have a self-limiting illness that can be managed considerately. Moreover, only 15% of pharyngitis is caused by GABHS and most of them are viral in children. In order to enhance rational antibiotic prescribing in adult patients, the CDC recommends that antibiotic prescribing be limited to those patients with the highest likelihood of GABHS using clinical decision criteria. This involves scanning of all adults with pharyngitis for the presence of the four main criteria which are the history of fever, acute tonsillitis, no cough, and tender anterior cervical adenopathy. Screening is only recommended for patients with two or more of the same criteria. These patients should be tested using a rapid antigen test and antibiotic therapy limited to patients with a positive test. Treating patients with none or only one of these criteria is not recommended because these patients are unlikely to have a bacterial infection. Antibiotic over-prescribing entails an increase in cost, side effects, and the emergence and spread of resistant bacteria. These bacteria become resistant to affordable and effective first- line antibiotics, a situation that is worsened by the fact that the development of new generations of antibiotics is not promising. Some of the reasons that lead to antibiotic overuse are diagnostic uncertainty, time pressure, patient demand and expectations (Gonzales et al.).Suggested that judicious use of these drugs can reduce undesirable adverse effects of antibiotics and the evolution of antimicrobial resistance. Some of the proven ways that help 34
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reduce antibiotic over-prescribing in essential healthcare are patient education and delayed antibiotic prescribing. Patient education by providing leaflets that describes the nature and expected course of their illness and discloses the uncertainty of benefit from treatment with antibiotics. Delaying antibiotic use by giving the patient a prescription and instructing them only to have it filled if symptoms do not resolve is also an effective means of reducing antibiotic use for acute respiratory infections. 2.7 Limitation The study only looks at 106 health facilities that submitted claims on the electronic claims platform. Over 3000 facilities that present paper claims were not analysed. Hence the conclusions should be interpreted in the context of the limited scope of the research. 2.8 Conclusion Failure to accordingly prescribe as per the clinical guidelines is one of the problems associated with the irrational use of medicines. The low compliance with the guidelines for specific illnesses implies a high prevalence of unreasonable prescribing. Moreover, if antibiotic treatment is indicated for pharyngitis or tonsillitis, compliance to guidelines is crucial to avoid
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  • It, ........., Upper respiratory tract infection, URTIs

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