Broad-Spectrum Antibiotics are overprescribed for Pharyngitis in Saudi Arabia

Pharyngitis is upper respiratory tract inflammation of the mucous membranes that line the back of the throat known as pharynx. This inflammation can cause dryness, discomfort, and difficulty swallowing (Rutter et al., 2015). The leading cause is a bacterial pathogen called Streptococcus pyogenes or Group A Streptococcus (GAS). Generally, Complications of GAS infections is not common, but, when occurred it turn to very serious health issues like scarlet fever, rheumatic fever, acute glomerulonephritis, streptococcal toxic shock syndrome, and pediatric autoimmune neuropsychiatric disorders.

According to the Centers for Disease Control and Prevention (CDC) (2018), GAS pharyngitis treatment is effective by taking the right type of antibiotics in order to prevent its complications. Cases of GAS pharyngitis are identified on the basis of clinical examination, patient history, and diagnostic tools.

Wolford et al. (2020) informed that a modified Centor score is calculated for suspected GAS cases. A score higher than three indicates the likely need for antibiotics, and a score between two and three requires further confirmation by diagnostic tools like rapid antigen detection tests (RADTs) and throat cultures. Therefore, appropriate diagnosis and selection of antibiotics are vital for proper treatment of GAS.

Alhomoud et al. (2017) informed that amoxicillin and penicillin V are the first-line antibiotics and these antibiotics have been unnecessarily prescribed. This misuse has been related to bacterial resistance while the geographical areas with more antibiotic use have higher antibiotic resistance rates.

Alnemri et al. (2016) studied that antibiotic prescription rates have been high in Saudi Arabia. Most of these antibiotics are being used for the treatment of upper respiratory tract infections. Therefore, several measures have been employed to reduce inappropriate antibiotic prescriptions and use. These include prohibiting self-prescriptions of antibiotics in private pharmacies, publishing the Saudi Acute Respiratory Infections guidelines, and establishing the Saudi Antimicrobial Stewardship Program (Al-Mohamadi et al. 2013)

Recent research presented by Olwi et al. (2021) that published in ‘Journal of infection in developing countries’ showed that antibiotics are overprescribed in Saudi Arabia and the majority of prescriptions were second-line (broad-spectrum) antibiotics. Although, physicians had sufficient knowledge of the modified Center score criteria and the recommended management of pharyngitis. Awkwardly, this was not fully implemented into their practice. Further studies are required for the policymakers and governing institutions to implement the optional management of pharyngitis to maximize the effectiveness.

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