Linee guida
La faringotonsillite in età pediatrica
Aggiornamento delle linee guida della Regione Emilia-Romagna
Acute pharyngitis in childhood.
Update of the guidelines of Emilia-Romagna Region
Simona Di Mario1, Carlo Gagliotti2, Maria Luisa Moro2, a nome del Gruppo "ProBA"
1Centro di documentazione sulla salute perinatale e riproduttiva - SaPeRiDoc, Servizio Assistenza Territoriale, Direzione generale sanità e politiche sociali e per l’integrazione; 2Area Rischio Infettivo, Agenzia Sanitaria e Sociale Regionale - Regione Emilia-Romagna, Bologna
Settembre 2015 - pagg. 442 -447
Abstract
This guideline on acute pharyngitis in childhood updates the guideline published by the
Emilia-Romagna Region in 2007. Acute pharyngitis is a frequent condition in childhood,
causing repeated clinical visits, emergency department visits, and inappropriate antibiotic
prescribing. For the management of pharyngitis, it recommends the use of the McIsaac
clinical score associated, in selected patients, with the rapid antigen detection test (RADT)
and the prescription of amoxicillin when an antibiotic treatment is needed. Changes from
2007 guideline mainly refer to the diagnostic algorithm, simplified to achieve a wider implementation
by health professionals. It confers a similar accuracy to the diagnostic
process than the previous one but it is more cost-effective, as it results from the cost-effectiveness
analysis. The guideline, based on the GRADE methodology, was developed by a
multi-professional group of regional experts and externally revised.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Contenuto riservato
Per leggere l'articolo completo è necessario effettuare il login.
Non sei ancora registrato? Registrati
Bibliografia
1. Michigan Quality Improvement Consortium
Guideline 2013. Acute pharyngitis in
children 2-18 years old. Southfield (MI): Michigan
Quality Improvement Consortium
Guideline, Jan 2013.
2. Hersh AL, Jackson MA, Hicks LA; American
Academy of Pediatrics Committee on Infectious
Diseases. Principles of judicious antibiotic
prescribing for upper respiratory
tract infections in pediatrics. Pediatrics 2013;
132:1146-54.
3. Di Mario S, Gagliotti C, Asciano M, Moro
ML (per il comitato tecnico scientifico regionale
dei pediatri “progetto proba-II fase”). La
faringotonsillite e l’otite media acuta in età
pediatrica. La guida rapida sviluppata dalla
Regione Emilia-Romagna. Medico e Bambino
2008;27:38-42.
4. Gagliotti C, Buttazzi R, Moro ML, Di Mario
S. Uso di antibiotici e resistenze antimicrobiche
in età pediatrica. Rapporto Emilia-
Romagna, 2014. Bologna, agosto 2015.
5. Gagliotti C, Buttazzi R, Pan A, Moro ML.
Uso di antibiotici e resistenze antimicrobiche
in età pediatrica. Rapporto Emilia-Romagna,
2009. Bologna, giugno 2011.
6. Gagliotti C, Buttazzi R, Nobilio L, Tomesani
A, Alboresi S, Moro ML. Uso di antibiotici sistemici
e resistenze antibiotiche nella popolazione
pediatrica dell’Emilia-Romagna. Rapporto.
Regione Emilia-Romagna, Bologna, ottobre
2006. http://assr.regione.emilia-romagna.it/
it/servizi/pubblicazioni/rapporti-documenti/
rapporto-emilia-romagna-2006-uso-di-antibiotici-
e-resistenze-antibiotiche-nella-popolazione-
pediatrica-dell2019emilia-romagna.
7. Gagliotti C, Buttazzi R, Di Mario S, Morsillo
F, Moro ML. A regionwide intervention to
promote appropriate antibiotic use in children
reversed trends in erythromycin resistance to
Streptococcus pyogenes. Acta Paediatr 2015;
104(9):e422-4.
8. Di Mario S, Gagliotti C, Moro ML. Faringotonsillite
in età pediatrica. Linea guida regionale.
Bologna, maggio 2015. http://assr.
regione.emilia-romagna.it/it/servizi/pubblicazioni/
dossier/doss253.
9. Faringotonsillite in età pediatrica. Guida
rapida 2015. http://assr.regione.emilia-romagna.
it/it/servizi/pubblicazioni/rapporti-documenti/
faringotonsillite-guida-rapida-2015.
10. Locandina Batti mani a chi si lava le mani.
http://salute.regione.emilia-romagna.it/documentazione/
materiale-informativo/locandine/
A3_CMYK_locandina_sapone.pdf.
11. WHO-World Health Organization. The
WHO Child Growth Standards. Ginevra,
2009. http://www.who.int/childgrowth/standards/
en/.
12. Risultati del questionario on-line rivolto ai
genitori. http://assr.regione.emilia-romagna.
it/it/aree_attivita/rischio-infettivo/progetti/
proba/risultati-questionario.
13. Piñeiro Pérez R, Hijano Bandera F, Alvez
González F, et al. Consensus document on
the diagnosis and treatment of acute tonsillopharyngitis.
An Pediatr (Barc) 2011;75:
342.e1-13.
14. Fine AM, Nizet V, Mandl KD. Large-scale
validation of the Centor and McIsaac scores
to predict group A streptococcal pharyngitis.
Arch Intern Med 2012;172:847-52.
15. Tanz RR, Gerber MA, Kabat W, Rippe J,
Seshadri R, Shulman ST. Performance of a
rapid antigen-detection test and throat culture
in community pediatric offices: implications
for management of pharyngitis. Pediatrics
2009;123:437-44.
16. BET - Best evidence topic reports. BET 3:
Can throat examination distinguish between
bacterial and viral infective agents? Emerg
Med J 2010;27:790-2.
17. Shulman ST, Bisno AL, Clegg HW, et al.;
Infectious Diseases Society of America. Clinical
practice guideline for the diagnosis and
management of group A streptococcal
pharyngitis: 2012 update by the Infectious
Diseases Society of America. Clin Infect Dis
2012;55:e86-e102.
18. De Martino M, Mansi N, Principi N, Serra
A. Gestione della faringotonsillite in età
pediatrica. Dipartimento di scienze per la salute
della donna e del bambino, Università
degli Studi di Firenze, Azienda Ospedaliero-
Universitaria Anna Meyer. Firenze, 2012.
19. NICE - National Institute for Health and
Clinical Excellence. Centre for Clinical Practice.
Respiratory tract infections - antibiotic
prescribing. Prescribing of antibiotics for
self-limiting respiratory tract infections in
adults and children in primary care (Clinical
guide-line, n. 69). Londra (UK), luglio 2008,
ribadita nel 2012.
20. SIGN - Scottish Intercollegiate Guidelines
Network. Management of sore throat and indications
for tonsillectomy. A national clinical
guideline, n. 117. April 2010.
21. Pastore S, De Cunto A, Benettoni A, Berton
E, Taddio A, Lepore L. The resurgence of
rheumatic fever in a developed country area:
the role of echocardiography. Rheumatology
(Oxford) 2011;50:396-400.
22. Essop MR, Peters F. Contemporary issues
in rheumatic fever and chronic rheumatic
heart disease. Circulation 2014;130:2181-8.
23. Spinks A, Glasziou PP, Del Mar CB. Antibiotics
for sore throat. Cochrane Database
Syst Rev 2013;11:CD000023.
24. Altamimi S, Khalil A, Khalaiwi KA, Milner
RA, Pusic MV, Al Othman MA. Short-term late-
generation antibiotics versus longer term
penicillin for acute streptococcal pharyngitis
in children. Cochrane Database Syst Rev
2012;8:CD004872.
25. Lieberman P, Nicklas RA, Oppenheimer J,
et al. The diagnosis and management of
anaphylaxis practice parameter: 2010 update.
J Allergy Clin Immunol 2010;126:477-80.e1-42.
26. Snellman L, Adams W, Anderson G, et al.
Institute for Clinical Systems Improvement.
Diagnosis and Treatment of Respiratory Illness
in Children and Adults. http://bit.ly/RespIll.
Updated January 2013.
27. Guyatt G, Gutterman D, Baumann MH, et
al. Grading strength of recommendations
and quality of evidence in clinical guidelines:
report from an American college of chest
physicians task force. Chest 2006;129:174-81.
Corrispondenza: sdimario@regione.emilia-romagna.it
