Following National Guidelines and Treatment to Eradicate Streptococcus Pharyngitis in Pediatrics

Author

Rosa I. Montenegro, The University of Texas at El Paso

Date of Award

5-2024

Degree Type

DNP Project

Degree Name

Doctor of Nursing (ND)

Department

Nursing

Chair

Alejandra B. Valenzuela

Abstract

Introduction: Sore throat (acute pharyngitis) is considered a prevalent disease worldwide among children and adults that requires healthcare. It is important to know that the etiology of sore throat in 70%-95% of cases is viral. Streptococcus pyogenes (group A streptococcus) is detected in approximately 15%-30% of all cases with sore throat, 5%-15% in adults, while 20%-30% in children. For the diagnosis of GAS infection, a throat swab is the gold standard procedure. Most guidelines are based on the seriousness of GAS infection to support the decision on the use of antibiotic treatment. All guidelines on sore throat give recommendations on the use of antibiotic therapy. First-line treatments are penicillin-based medications. Macrolides or cephalosporins are commonly recommended as second-line antibiotics when allergy to penicillin is present. Amoxicillin/clavulanate is infrequently recommended as a second-line antibiotic for sore throat. Only four guidelines recommend topical treatments such as lozenges, gargles, or sprays for analgesic treatment.

Aim/Methods: The quality improvement project was to follow National Guidelines to treat Staphylococcus Pharyngitis by doing a rapid antigen strep test to evaluate patients that were symptomatic with fever, no cough, enlarged cervical lymph nodes, and a sore throat. Penicillin or Amoxicillin 25 mg/kg/dose was prescribed if patients were not allergic to penicillin. If allergy to penicillin was present, Azithromycin 12 mg/kg/dose was prescribed. These patients followed-up in 2 weeks for a rapid antigen strep test. This project was conducted in a primary care pediatric clinic over a period of six weeks. Patients aged 5-17 years of age diagnosed with streptococcus pharyngitis were treated and education was provided by following national guidelines.

Results: Eighty-two patients met the criteria and were included in the QI project. Fifty-nine initiated and completed treatment. The primary goal was for patients to test negative at the two-week follow-up. Thirty-five patients tested negative at the two-week follow-up, nineteen patients tested positive, and twenty-three patients were lost to follow-up.

Conclusions: Following national guidelines when it comes to treating streptococcus pharyngitis proved to be highly successful. Children completed their antibiotic as prescribed and followed the educational recommendations.

Recommended Citation

Montenegro, Rosa I., "Following National Guidelines and Treatment to Eradicate Streptococcus Pharyngitis in Pediatrics" (2024). Cohort XII. 5.
https://scholarworks.utep.edu/cohort_12/5