Modified Centor Criteria and antibiotic prescription for patients diagnosed with tonsillopharyngitis

1. AimThe main aim was to assess whether there was an association between the Modified Centor Criteria (MCC) and antibiotic prescription and if there was adherence to the national guidelines for antibiotic prescription2. MethodA cross-sectional study, based on a representative sample of 87 GPs, was conducted during 4 weeks in November 2019. All patients with an episode of acute respiratory infection were involved in the survey. We used the same questionnaire from a previous survey done in 2014/2015. A total of 3244 patients were diagnosed with tonsillopharyngitis. All analyses were performed using RStudio.3. Results431 children aged less than 3 years and 9 patients with missing values for age were excluded. 2804 patients, aged from 3 to 91 years (median 16 years), were included in the analysis. Low MCC (-1, 0, 1, 2) was present in 1658 (59.1%) patients and high MCC (3, 4, 5) was present in 1146 (40.9%) patients. Patients with low MCC were 27% less likely to be prescribed an antibiotic than those with high MCC (RR, 0.73; 95% CI, 0.70 – 0.77; p < 0.001). Antibiotics were unnecessarily prescribed for 1037 (62.6%) patients with low MCC. Overall, 2016 (71.9%) patients received a prescription for an antibiotic. The most prescribed antibiotic was amoxicillin with clavulanic acid to 736 (37.5%) patients. Penicillin V, which is the first-line choice, was prescribed to 320 (16.3%) patients. Only 224 (11.1%) patients were treated according to the guideline (Penicillin V in patients with high MCC).4. ConclusionAlthough low risk patients were less likely to get an antibiotic prescription than high risk patients, they still received unnecessary antibiotic therapy. There was low adherence in prescription of the first-line choice of antibiotic according to the national guidelines. Including MCC in the daily practice of GPs can improve rational antibiotic prescription. Implementation Science/Service Development Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest No competing interest to declare References and Clinical Trial Registry Information