In multiple video meetings and email correspondence from March to November 2022 and finally in a workshop at the annual meeting for the North American Primary Care Group in November 2022, experts from different countries representing different traditions agreed on how the current evidence should be interpreted.
This critical analysis identifies that the problem can be resolved by introducing a new triage scheme considering both the acute risk for suppurative complications and sepsis as well as the long-term risk of developing rheumatic fever.
The new triage scheme may solve the long-standing problem of advocating for a restrictive use of antibiotics while also satisfying concerns that critically ill patients might be missed with severe consequences. We acknowledge that the perspective of this problem is vastly different between high- and low-income countries. Furthermore, we discuss the new trend which allows nurses and pharmacists to independently manage these patients and the increased need for safety netting required for such management.
在2022年3月至11月的多次视频会议和电子邮件通信中,以及最后在2022年11月的北美初级保健小组年会上的研讨会上,来自代表不同传统的不同国家的专家就如何解释当前证据达成了一致。
■这项关键分析确定,通过引入新的分诊方案可以解决该问题,同时考虑化脓性并发症和败血症的急性风险以及发展为风湿热的长期风险。
新的分诊方案可能会解决长期以来提倡限制使用抗生素的问题,同时也会解决危重病人可能因严重后果而错过的担忧。我们承认,高收入国家和低收入国家对这一问题的看法大不相同。此外,我们讨论了允许护士和药剂师独立管理这些患者的新趋势,以及这种管理对安全网的需求增加。