Premium
Treatment of sore throat in light of the Cochrane verdict: is the jury still out?
Author(s) -
Danchin Margaret H,
Curtis Nigel,
Carapetis Jonathan R,
Nolan Terence M
Publication year - 2002
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2002.tb04925.x
Subject(s) - pharyngitis , medicine , sore throat , antibiotics , penicillin , intensive care medicine , throat , throat culture , acute pharyngitis , surgery , streptococcus , microbiology and biotechnology , genetics , bacteria , biology
There are few good‐quality studies of the effectiveness of antibiotic treatment of proven group A streptococcal (GAS) pharyngitis in children; available data suggest that antibiotics may reduce symptom duration. While there is limited justification for antibiotic treatment of GAS pharyngitis to prevent acute rheumatic fever in non‐Indigenous Australians, there is no justification for routine antibiotic treatment of all patients with sore throat. Two strategies are open to clinicians: not to treat GAS pharyngitis with antibiotics, in which case no investigations should be done; or to treat cases of sore throat with clinical features that suggest GAS, in which case diagnosis should be confirmed with a throat swab, and penicillin started while awaiting the result. Penicillin should be discontinued if the swab is negative, or continued for 10 days if it is positive for GAS. Surveillance of GAS infections and acute rheumatic fever is needed in Australia, as are further studies of effectiveness (including cost‐effectiveness) of antibiotic treatment of proven GAS pharyngitis.