Pre-hospital antibiotic treatment of meningococcal disease: scope for improvement.
The New Zealand medical journal · 2003-09-26 · Observational study
Abstract
AIM: To determine the extent to which Auckland general practitioners (GPs) follow Ministry of Health guidelines recommending the administration of pre-hospital antibiotic treatment to suspected cases of meningococcal disease. METHODS: Retrospective audit of notified cases of meningococcal disease referred by Auckland GPs from 1 May 2001 to 30 April 2002. RESULTS: Of 142 meningococcal disease cases that were referred to hospital by GPs, 111 (78%) were 'eligible' or met Ministry of Health guideline criteria for pre-hospital antibiotic treatment. Of these, only 33 (30%) were given parenteral antibiotics. Those with a rash were twice as likely as those without a rash to receive antibiotics (RR 2.1; 95% CI 1.7-2.7). There was no difference in antibiotic administration by age, sex, ethnicity, or where there was an estimated delay of greater than 30 minutes to assessment in hospital. CONCLUSIONS: The findings of this audit reinforce the need for GPs to have a higher index of suspicion and lower threshold for treatment for suspected cases of meningococcal disease and to give antibiotics more often than they do at present.