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Appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria

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Abstract

Background Inappropriate use of antibiotic treatment for pharyngitis by community pharmacists is prevalent in developing countries. Little is known about how the pharmacists identify patients with bacterial pharyngitis. Objective To ascertain the appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria and to identify factors related to antibiotic dispensing. Setting 1040 Thai community pharmacists. Method A cross-sectional survey of community pharmacists was conducted in November 2012 to March 2013. The self-administered questionnaires were mailed to 57 % of community pharmacists in the south of Thailand (n = 1040). The survey included questions on diagnosis of streptococcal pharyngitis, knowledge on pharyngitis, and attitudes and control beliefs regarding antibiotic dispensing. Main outcome measure The appropriateness of diagnosis of streptococcal pharyngitis according to the original and modified Centor criteria and determinants of antibiotic dispensing including demographic characteristics of pharmacists, knowledge on pharyngitis, and attitudes and control beliefs on antibiotic dispensing. Results Approximately 68 % completed the questionnaires (n = 703). Compared to the pharmacists who reported not dispensing antibiotics in the hypothetical case with common cold, those reported dispensing antibiotics were more likely to consider the following conditions—presence of cough, mild sore throat and patients with age >60 years as cues for diagnosis of streptococcal pharyngitis (p < 0.05). The use of fewer scores of the clinical prediction rules for diagnosis was observed in antibiotic dispensers, compared to who did not do so (p < 0.005). Antibiotic dispensing was positively associated with period of dispensing experience (>5 years) [odds ratio (OR) 1.52; 95 % confidence interval (CI) 1.03–2.23], belief that antibiotics could shorten duration of pharyngitis (OR 1.48; 95 % CI 1.11–1.99), belief that antibiotics could prevent the complications (OR 1.44; 95 % CI 1.09–1.91) and belief that dispensing antibiotics could satisfy the patients (OR 1.31; 95 % CI 1.01–1.71). Nonetheless, antibiotic dispensing was negatively associated with knowledge about pharyngitis (OR 0.83; 95 % CI 0.75–0.93). Conclusion Pharmacists who are knowledgeable on the Centor criteria are more likely to appropriately diagnose streptococcal pharyngitis and less likely to dispense antibiotics in such case.

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Acknowledgments

We gratefully acknowledge all community pharmacists who participated in this study. We wish to thank the lecturers and graduate students of the Faculty for their assistance in questionnaire development. Finally, we thank Dr. Alan Geater for English editing.

Funding

This work was supported by Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand (PSU.598/W.812).

Conflicts of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand

    Woranuch Saengcharoen, Pornchanok Jaisawang, Palita Udomcharoensab & Kittika Buathong

  2. Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand

    Sanguan Lerkiatbundit

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  1. Woranuch Saengcharoen
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Correspondence to Woranuch Saengcharoen.

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Saengcharoen, W., Jaisawang, P., Udomcharoensab, P. et al. Appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria. Int J Clin Pharm 38, 1318–1325 (2016). https://doi.org/10.1007/s11096-016-0373-7

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