Antibiotic use in the emergency department for acute sore throat

Acute sore throat is a frequent cause of inappropriate antibiotic prescribing in primary care, despite the majority of cases being viral in nature. Following changes in consulting behaviour, many patients are now turning to emergency departments for their primary care needs. The aim of this study was to determine whether clinical scores are used between staff groups when treating acute tonsillitis in an emergency department and whether antibiotics are prescribed appropriately. A retrospective service evaluation of patients diagnosed with ‘tonsillitis’ in the emergency department over a 12-month period was conducted. Patient records were reviewed for Centor or FeverPAIN scoring documentation, antibiotic prescriptions and the clinician group providing treatment. The review found that a clinical score was documented for only 38 patients and that 44% of antibiotics were prescribed inappropriately. It is concluded that clinical scores are not being used appropriately in the emergency department to guide antibiotic prescribing for tonsillitis, leading to a high number of inappropriate prescriptions.