Improving Adherence to Group A Streptococcal Pharyngtitis Guidelines to Decrease Unnecessary Antibiotics

Abstract

Acute pharyngitis is one of the most common upper respiratory infections seen in primary offices, and the most commonly prescribed medications are antibiotics. The most common bacteria causing symptoms of sore throat is group A streptococci and this accounts for 20-30% in children, and 4-15% in adults (Shulman et al., 2012). Utilization of Rapid Antigen Detection Test (RADT) providers can safely avoid the overuse of antibiotics (Shulman et al., 2012). Without laboratory confirmation providers relying on clinical judgement alone are over estimating the disease by 80-95% (Sarrell, Giveon, 2012). In the case at a rural health department a chart analysis concluded providers were prescribing antibiotics 58.3% of the time for negative test results. The purpose of this scholarly project is to improve the adherence of the Infectious Diseases Society of America clinical practice guidelines to group A streptococcal pharyngitis in a local health department to help decrease unnecessary prescribing of antibiotics and decrease potential drug resistance. A retrospective chart analysis was conducted to determine a need assessment. With a need for improvement education and a luncheon was provided for clinical staff. With education and implementation of a new standardized process guideline adherence for group A streptococcal pharyngitis increased from 58.3% to 95% thus, increasing patient safety and decreasing patient cost. Decreasing unnecessary prescribing of antibiotics leads to decrease antibiotic resistance, and quality improvement projects similar to this project and potentially decrease antibiotic resistance by adhering to clinical practice guidelines.