Score of Joachim for Evaluating a Pediatric Patient with Pharyngitis in a Low-Resource Setting

Description

Joachim et al developed a pragmatic score for evaluating pediatric patients with pharyngitis in a low-resource setting. This can reduce unnecessary antibiotic therapy in some patients. The authors are from Queen Fabiola University Children's Hospital, University of Brussels and University of Brasilia.

Patient selection: pediatric patient from 0 to 15 years of age

Parameters:

(1) age in months

(2) 5 bacterial signs (items 2 to 6: tender lymph nodes, headache, petechiae, abdominal pain, sudden onset)

(3) 3 viral signs (items 7 to 9: conjunctivitis, coryza, diarrhea)

Parameter	Finding	Points
age in months	<= 35 months	1
	36 to 59 months	2
	>= 60 months	3
tender cervical lymph nodes	absent	0
	present	1
headache	absent	0
	present	1
petechiae on the palate	absent	0
	present	1
abdominal pain	absent	0
	present	1
sudden onset (< 12 hours)	absent	0
	present	1
conjunctivitis	absent	0
	present	1
coryza	absent	0
	present	1
diarrhea	absent	0
	present	1

total score =

= (points for age) + (points for bacterial signs) - (points for viral signs)

Interpretation:

• minimum score: -2

• maximum score: 8

Score	No Bacteriologic Resources	Bacteriologic Resources Available
<= 2	symptomatic therapy	symptomatic therapy
3	antibiotic	antibiotic if rapid antigen test positive
>= 4	antibiotic	antibiotic

Performance:

• The area under the ROC curve was 0.66.

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Score of Joachim for Evaluating a Pediatric Patient with Pharyngitis in a Low-Resource Setting

Description

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