STREPTOCOCCAL DIAGNOSTIC TESTING AND ANTIBIOTICS PRESCRIBED FOR PEDIATRIC TONSILLOPHARYNGITIS

Background, This study examined a 1-year cross-sectional sample of Ken tucky Medicaid claims for the use of streptococcal diagnostic tests fo r pediatric tonsillopharyngitis and the empiric use of antibiotics, Me thods. Subjects were individuals older than 3 and younger than 18 year s old seen in an ambulatory setting for tonsillopharyngitis; 3478 indi viduals accounted for the 5067 separate outpatient and emergency room encounters for pediatric tonsillopharyngitis; 849 encounters coded as streptococcal sore throat were also examined. Results. Diagnostic test s for group A streptococcal tonsillopharyngitis were performed in only 22% (n = 1130) of the tonsillopharyngitis encounters and 36% (n = 306 ) of the streptococcal sore throat encounters. Urban physicians were m ore likely than rural physicians to use a diagnostic test (P = 0.0001) . Emergency room encounters and outpatient encounters were not signifi cantly different in the likelihood of having a diagnostic test (P = 0. 16). In encounters for tonsillopharyngitis antibiotics were prescribed in 72% of the total encounters and in 73% of the encounters without a diagnostic streptococcal test. In encounters for streptococcal sore t hroat, antibiotics were prescribed for 68% of the total encounters and 69% of the encounters without a diagnostic streptococcal test. Conclu sions. Current practices in the Kentucky Medicaid program do not follo w the American Academy of Pediatrics guidelines for streptococcal tons illopharyngitis.