TRENDS IN ANTIBIOTIC RESISTANCE IN ACUTE TONSILLITIS: A TERTIARY CARE CENTER EXPERIENCE
Main Article Content
Keywords
Tonsillitis, Antibiotic Resistance, Streptococcus, Tertiary Care
Abstract
Background: Acute tonsillitis, which is frequently triggered by Streptococcus progenies. Antibiotics are the backbone of a therapeutic regimen; however, antibiotic resistance has emerged as a serious clinical problem. The problem has been worsened by misuse and over-prescribing especially in tertiary care facilities where empirical therapy is common. It is also necessary to monitor the trend of the resistance in order to have the best management techniques and guarantee treatment.
Objectives: To determine a pattern in the development of antibiotic resistance of acute tonsillitis, and to assess the role it plays in empirical treatment in the environment of close care hospital.
Study design: A Prospective Study.
Place and duration of study: Department of ENT Khyber Teaching Hospital Peshawar KPK Pakistan from 10-july 2022 to 10-Dec 2022
Methods:
It is a prospective observational study set at a tertiary care hospital over two years. The throat swab cultures and sensitivity testing was performed on patients who were clinically diagnosed with acute tonsillitis. Isolation of organisms, including determination of antibiotic resistance, was performed according to standard microbiological procedures. SPSS was used to analyze the data and the statistical significance was obtained to be p < 0.05. Chi-square tests and t-tests were used to record and analyze demographic data, resistance rates, and temporal trends.
Results:
The patients admitted were 50 in number. The average age was 24.6 +/- 9.8 years. The most preoccupied isolate was Streptococcus progenies. Azithromycin and amoxicillin had high resistance (45 and 30 percent, respectively), whereas sensitivity to cefixime was maintained above 85 percent. The p-value of the difference in resistance between age groups was 0.032, which is significant and suggests that there is a relationship between the variables. The trend of resistance was mild over the two years highlighting the need of regular surveillance and specific treatment in younger adults.
Conclusion:
The study paper shows that there is an increasing level of antibiotic resistance in acute tonsillitis-causing bacteria, especially to those that are well-known such as azithromycin. Empirical usage without culture sensitivity can increase the resistance rates. Antibiotics should only be started after clinicians consider local antibiograms. Post discharge surveillance and patient education remain essential elements of a quality antibiotic stewardship program at tertiary care level.
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Imran Khan
Assistant Professor ENT Department Khyber Teaching Hospital Peshawar KPK Pakistan
Muhammad Afaq Ali
Assistant Professor ENT DHQ Teaching Hospital Dera Ismail Khan KPK Pakistan
Shakir Ullah
Registrar ENT Department Khyber Teaching Hospital Peshawar KPK Pakistan
Nasim Jan
Registrar Lady Reading Hospital Peshawar KPK Pakistan
Arshad Abbas
Associate Professor Gajju khan Medical College Swabi KPK Pakistan
Mushtaq Ahmad
PGR ENT Department Khyber Teaching Hospital Peshawar KPK Pakistan