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Master Thesis

Le Test de Diagnostic Rapide dans l'angine est-il un enjeu de santé publique en Savoie ?

Abstract : Since 2002, the use of rapid streptococcal antigen detection tests (RADTs) aims to decrease the unjustified use of antibiotics in sore throats which are 50 to 90% of cases viral.The main purpose is to assess the use of RADTs by general practitioners (GPs) in Savoie and to identify barriers to their usage. The secondary purpose is to compare the evolution of RADTs’ orders at a national, regional and departmental level. This is quantitative descriptive blind study by interviewing GPs of Savoie and study of french institutions. 23,3% of answers. 94% of answering GPs report to use RADT. 49% of GPs systematically use RADT, 45% of them use it depending on the age of the patient or the clinic.The performance of RADTs is easy according to 49% of users, fast for 14% and 27% believe that RADTs allow a better acceptance of the GPs’ therapeutic decision. Only 30% of users perform the Mac Isaac clinical score and 24% use the clinical score in addition to the RADT upon recommendation of the ANSM. 64% of practitioners sometimes prescribe an antibiotic if the RADT is negative. 99% of GPs prescribe amoxicillin in case of Group A streptococci. Among 6% of non-users, 67% use the score and 83% prescribe antibiotics depending on the clinic. The limiting factors are the uselessness of RADT’s in the decision, the unreliability and the use of clinical score. In France RADTs’ orders tend to decrease since 2005 whereas they tend to increase in Savoie and Rhône Alpes. In 2009, 32% of the beneficiary GPs have ordered at least once the RADT in France, and 48,7% in our region and 58,2% in 2013 in our department. The main limit is a bias in recruitment, related to the high percentage of users. RADT is a decisive tool widely used by GPs in Savoie. Its wide use in Savoy may partly explain that this department is the second lowest antibiotic consuming department in France (where consumption of antibiotics is low), close to the average prescription rate in Europe. The interest of GPs in other RADT is encouraging and promising for the future in Public Health.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01077874
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Submitted on : Monday, October 27, 2014 - 2:20:02 PM
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Tiphaine Girard. Le Test de Diagnostic Rapide dans l'angine est-il un enjeu de santé publique en Savoie ?. Médecine humaine et pathologie. 2014. ⟨dumas-01077874⟩

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