title: Nonadherence to guidelines for prescribing antibiotic therapy to patients with tonsillitis or pharyngotonsillitis: a cross-sectional study.
abstract: OBJECTIVE
  Although previous studies have assessed nonadherence to guidelines for prescribing antibiotic therapy in patients with pharyngotonsillitis (prescription of another antibiotic rather than one of first choice: amoxicillin and/or penicillin V, except in the case of penicillin allergy), none analyzed associated factors. Consequently, we conducted a study to assess the possible factors associated with the problem of nonadherence.
  
  
  METHODS
  This cross-sectional study analyzed a sample of 417 patients with tonsillitis or pharyngotonsillitis treated with antibiotics during February 2014 in a Spanish region. The data were obtained through electronic records.
  
  
  METHODS
  gender, disease (tonsillitis or pharyngotonsillitis), clinical specialty (primary care or pediatrics), age and physician's gender. To identify factors associated with nonadherence, the adjusted odds ratios (ORs) were calculated through a binary logistic regression model with all the independent variables. The confidence interval (CI) was calculated for all relevant parameters.
  
  
  RESULTS
  Of 417 patients, 303 were categorized to the nonadherence group (72.7%, 95% CI: 68.4-76.9%). Two factors associated with the physician were relevant and close to statistical significance: primary healthcare as a clinical specialty (OR = 2.3, p = 0.055) and male gender (OR = 1.5, p = 0.088).
  
  
  CONCLUSIONS
  Nonadherence in prescribing first-choice antibiotics to patients with tonsillitis or pharyngotonsillitis is highly prevalent. We emphasize the need to implement measures to help minimize this problem and, thus, antibiotic resistance, such as undertaking qualitative studies to assess the reasons for inappropriate prescription or the incorporation of alert systems in the electronic records.
  
  
  CONCLUSIONS
  As we analyzed data from all the patients in winter, it would be interesting to replicate this study at another time of the year.
authors: Pharmacy Service, General University Hospital of Elda , Elda , Spain.
authors: Pilar
authors: P
authors: Rico-Ferreira
authors: Antonio
authors: A
authors: Palazón-Bru
authors: Miriam
authors: M
authors: Calvo-Pérez
authors: Vicente Francisco
authors: VF
authors: Gil-Guillén
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D057970:Inappropriate Prescribing; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011320:Primary Health Care; D012141:Respiratory Tract Infections / Q000188:drug therapy; D012621:Seasons; D014069:Tonsillitis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibacterial agents; Guideline adherence; Inappropriate prescribing; Physicians, primary care; Physician’s practice patterns; Tonsillitis