Updated Finnish Guidelines Did Not Change the Use of Antibiotics for Children's Sore Throats.

Objective: Our goal was to evaluate the impact of the 2020 update to the Finnish Current Care Guideline on the treatment of paediatric pharyngitis and antibiotic prescriptions in a paediatric emergency department.

Methods: We conducted a retrospective before-and-after cohort study at Mikkeli Central Hospital, analysing paediatric patients diagnosed with pharyngitis or tonsillitis from July 2019 to June 2022. Data on clinical presentation, Centor scores, microbiological testing, and antibiotic prescriptions were collected and compared between the two periods.

Results: A total of 246 (47% female) patients were included in the before group and 219 (55% female) in the after group. The average age in the before group was 8.1 years ±4.3 and 10.0 years ±4.2 in the after group. The primary antibiotic prescribed was phenoxymethylpenicillin, 51% and 45% in the before and after groups respectively. Amoxicillin was prescribed more often after the update (difference 4.6%,95% confidence interval 2.0-8.5), but no other significant changes in antibiotic prescribing were observed. Only 13% of patients required a secondary visit, and suppurative complications were rare.

Conclusions: The update of current care guideline had no immediate impact on the antibiotic prescription patterns in a Finnish paediatric emergency department.