Author/Editor		Štrumbelj, Iztok
Title		Vloga betahemolitičnih streptokokov in Arcanobacterium haemolyticum pri vnetjih žrela
Type		monografija
Place		Ljubljana
Publisher		Univerza v Ljubljani, Medicinska fakulteta, Biotehniška fakulteta
Publication year		2000
Volume		str. 91
Language		slo
Abstract		More than 200 physicians from Slovenia have been asked about their management of patients with possible streptococcal pharyngitis (SP). Most questions were answered by 142, some questions by smaller number of physicians. Diagnosis of SP: 42% of physicians never use culture, 43 % of physicians use culture in less than 20 % of patients. A quarter of all physicians believe that, for practical purposes, negative throat culture rules out SP. Only 34% of physicians stop antibiotic treatment when the result of culture is negative. Results of the culture are available to the clinician later than 2 days after swabs have been taken in large majority of cases (84%). Treatment of SF: dose of penicillin for adult patients, prescribed by 76% of physicians is at least 4 millions IU daily, divided in 3 (half of physicians) or 4 doses (half of physicians also). Results of throat cultures from 300 patients with clinically suspected SP were studied. A simple scorecard for clinical tentative diagnosis of SP, developed by Breese (BSS), was evaluated in this population and performances compared with performance in original population (Breese). Three different methods for culture and identification of betahemolytic streptococci (BHS) and Arcanobacterium haemolyticum (AH) were compared. BSS is a simple system: clinical and epidemiological parameters are evaluated and scored and patients are categorized in four categories. Probability of SF has risen from the first to the fourth category in both populations. However, prevalence of SF in each category was lower in our population. A threshold for treatment must be chosen, if clinical scoring system is used as the only way for diagnosis of SF. We evaluated performance of BSS in our population with two possible thresholds for positivity. With lower threshold (positivity more than 25 points), sensitivity of the test was 0,91, specificity 0,24. (Abstract truncated at 2000 characters)
Descriptors		PHARYNGITIS STREPTOCOCCUS PYOGENES CORYNEBACTERIUM ANTIBIOTICS QUESTIONNAIRES STREPTOCOCCUS AGALACTIAE CHILD