Streptococcal pharyngitis among children: Comparison of attitudes between family physicians and pediatricians

Background: Streptococcal pharyngitis is a common problem among children and adolescents. There are differences in diagnostic and treatment approaches in streptococcal pharyngitis between family physicians and pediatricians. To our knowledge, this issue has not been investigated in Israel. Objective: To evaluate the attitude to diagnosis and treatment of streptococcal pharyngitis among family physicians and pediatricians in the southern part of Israel, and to explore the possible differences between these two populations. Methods: The study population consisted of a convenience sample of family physicians and pediatricians employed by Clalit Health Services in the Negev area. Anonymous questionnaires were self-administered to family physicians during clinic staff meetings or during participation in courses. The study included pediatricians working at Soroka University Medical Center and in the Negev community clinics. Results: The study included 52 family physicians and 50 pediatricians. The majority of the participants correctly evaluated the criteria for streptococcal pharyngitis (93%). A statistically significant difference (p<0.01) was found comparing the treatment approach of the two physician groups. Twenty seven family physicians (51.9%) begin empiric antibiotic treatment in cases with high probability of streptococcal pharyngitis, compared with only nine (18.8%) pediatricians. In this case, the majority of pediatricians prefer to complete the laboratory tests. Remarkable difference was found regarding the treatment approach. All the family physicians (100%) in the study recommended Rafapen treatment compared with twenty seven (57.4%) of the pediatricians (p<0.0001). Conclusions: It appears to be appropriate to plan and perform a large national study in order to formulate uniform guidelines for streptococcal pharyngitis.