Clinical predictors of childhood streptococcal pharyngitis
AbstractBackground Antibiotic prescription for the management of all acute
pharyngitis seems to be increasing recently. Streptococcal pharyngitis
is the one that has strong indication for antibiotic prescription. It
is quiet hard to distinguish the clinical features of streptococcal
pharyngitis from non-streptococcal one.
Objective To determine specifically clinical features of streptococcal
pharyngitis and distinguish them from non-streptococcal one.
Methods We conducted a cross-sectional study on children with
acute pharyngitis at Pediatric Outpatient Department Dr. M.
Djamil Hospital, Padang from November 2006 until March 2007.
Data on clinical features and pharyngeal swab culture results were
analyzed using chi-square test for clinical predictors. All were then
reanalyzed using multivariate logistic regression.
Results Ninety-five children aged 3-13 years were enrolled and
pharyngeal swab culture was performed. Group A Î² -haemolyticus
streptococcus was found in 13 children (14%). Absence of cough,
sore throat, tonsillar exudates and tender anterior cervical
adenopathy were the clinical predictors for streptococcal
pharyngitis and the last two shared highest risk (OR 55.05;
31.82). Combination of tonsillar exudates, tender anterior cervical
adenopathy and absence of cough contributed 99,3% probability.
Conclusions Streptococcal pharyngitis includes a small part of all
childhood with acute pharyngitis. High grade fever, sore throat,
absence of cough, tonsiller excudates and tender anterior cervical
adenopathy were considered as clinical predictors for childhood
streptococcal pharygitis. Combination of some clinical predictors
will strengthen the probability of streptococcal pharyngitis.
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