1140 Antibiotic Stewardship in Treating Glandular Fever Tonsillitis

Introduction Glandular fever is caused by Epstein-Barr virus. Antibiotics are not indicated in viral infections. A large number of patients who are hospitalised with sore throat will have Glandular fever with positive IM serology and be incorrectly treated with antibiotics without evidence of superimposed bacterial infection. Aim To assess the use of antibiotics in EBV positive patients with no signs of bacterial infection in NHS Lothian. Method A retrospective audit of 75 adult patients hospitalised with tonsillitis between August 2020 and July 2021. Data on diagnosis, inflammatory markers, EBV serology, and antibiotic use were collected and analysed. This was compared to previously reported NHS Tayside 4-year data between 2017 and 2020. Results Of the 75 tonsillitis admissions, 28% were IM Positive. Of these, 86% were discharged on antibiotics despite no evidence of concomitant bacterial infection. Similar figures were noted in NHS Tayside. Conclusions Glandular fever seems to be managed with antibiotics which goes against current best practice. Local and national ENT guidelines need to be updated and created, respectively.