How do GPs diagnose and manage acute infective conjunctivitis? A GP survey
How do GPs diagnose and manage acute infective conjunctivitis? A GP survey
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DOI：
10.1093/fampra/19.6.658
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发表时间：
2002-12-01
期刊：
影响因子：
2.2
通讯作者：
Little, P
中科院分区：
文献类型：
--
作者：
Everitt, H;Little, P
Objective.确定全科医生对急性感染性结膜炎（AIC）的诊断和管理，AIC是初级保健中最常见但研究最少的急性感染之一。对来自英格兰南部两个卫生当局的300名全科医生进行邮寄问卷调查。236名（78%）全科医生返回了问卷。92%的受访者对AIC的诊断感到自信或非常自信。95%的人通常为AIC开局部抗生素，尽管58%的人表示他们认为至少有一半的病例是病毒性的，只有36%的人认为他们可以区分细菌和病毒感染。全科医生使用个体体征诊断AIC（从99%使用眼分泌物到31%使用结膜水肿）以及用于区分病毒感染和细菌感染的特征（从87%使用分泌物类型到47%使用分泌物量）存在相当大的差异。全科医生很少进行眼拭子或给病人的信息传单与AIS患者。大多数全科医生仍然为大多数AIC病例开出局部抗生素处方-只有一半的病例可能是由于细菌感染，甚至细菌感染也是自限性的。需要进一步的研究来探索局部抗生素的潜在益处和缺点，并开发临床或微生物学方法来帮助全科医生靶向抗生素处方。
Objective. To determine GPs' diagnosis and management of acute infective conjunctivitis (AIC)-one of the commonest but least researched acute infections seen in primary care.Methods. A postal questionnaire survey of 300 GPs from two Health Authorities in Southern England.Results. 236 (78%) GPs returned the questionnaire. 92% of those responding felt confident or very confident in the diagnosis of AIC. 95% usually prescribe topical antibiotics for AIC despite 58% stating that they thought at least half of the cases they see are viral in origin and only 36% believing that they could discriminate between bacterial and viral infection. There was considerable variability in GPs' use of individual signs to make the diagnosis of AIC (from 99% using eye discharge to 31% using conjunctival oedema) and in the features used to discriminate viral from bacterial infection (from 87% using type of discharge to 47% using amount of discharge). GPs rarely perform eye swabs or give patient information leaflets to patients with AIC.Conclusion. Most GPs still prescribe topical antibiotics for most cases of AIC-a condition where only half of the cases are likely to be due to a bacterial infection, and even bacterial infections are self-limiting. Further research is needed to explore the potential benefits and disadvantages of topical antibiotics, and to develop clinical or microbiological methods to help GPs to target antibiotic prescription.