Acta Scientific Paediatrics (ISSN: 2581-883X)

Review Article Volume 4 Issue 1

Time to Use the Obliviate Spell for Mcisaac Score for Childhood Pharyngitis!!

Pearl Mary Varughese1*, Nandita Pai2 and Prakash M3

1Pediatric Specialist, KIMS Bellerose Institute of Medical Sciences Pvt. Ltd, Kottayam, Kerala, India
2Senior Clinical Fellow in Pediatrics, Royal London Hospital, London, United Kingdom
3Assistant Professor, Department of Community Medicine, Indira Gandhi Medical College and Research Institute, Pondicherry, India

*Corresponding Author: Pearl Mary Varughese, Pediatric Specialist, KIMS Bellerose Institute of Medical Sciences Pvt. Ltd, Kottayam, Kerala, India.

Received: November 25, 2020; Published: December 28, 2020

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Abstract

Background: Though most common aetiology of acute pharyngitis is viral, antibiotics are being started aimlessly in most cases without prior blood tests or throat swab culture reports. This not only causes unnecessary use of antibiotics, but also antibiotic resistance in the long run.

Objective: The primary objective was to validate McIsaac score for identification of bacterial pharyngitis. The secondary objective was to put forward an easy pragmatic clinical scoring system for diagnosing GAS infection in children.

Materials and Methods: This was an observational study conducted over a 24- month period. The inclusion criteria included all the children 3-15 years who visited the hospital with acute pharyngitis. Exclusion criteria included those on antibiotics or unidentified medication in the previous week, immunocompromised, or later found to have sinusitis, otitis media or pneumonia. Sensitivity, specificity and positive and negative LR was done for many contributing factors.

Results: The throat swab culture was positive only in 59 (72.8%) cases being Group A streptococcal pharyngitis. Palatal petechie had the best LR and a combination of factors (Positive CRP, Positive WBC; Presence of palatal petechiae and Exudates in tonsils) was a better predictive tool than McIsaac score. By using the modified score, there was only overuse of antibiotics in 5.9% cases.

Conclusion: Most of the acute pharyngitis cases are viral, requiring symptomatic management and parental reassurance. McIsaac score is not a useful tool and combination of factors (Positive CRP, Positive WBC; Presence of palatal petechiae and Exudates in tonsils) had better predictive value for diagnosing acute pharyngitis.

Keywords: McIsaac Score; Streptococcal Pharyngitis; Antibiotics

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Citation

Citation: Pearl Mary Varughese., et al. “Time to Use the Obliviate Spell for Mcisaac Score for Childhood Pharyngitis!!”. Acta Scientific Paediatrics 4.1 (2021): 19-27.




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