Rational decisions in managing sore throat: evaluation of a rapid test.
Sixty nine general practitioners recorded what they had prescribed for a total of 1189 episodes of sore throat. Antibiotics were prescribed in 763 (64%) episodes and broad spectrum antibiotics in 161 (21%) of these. If there was dysphagia, hoarseness, cervical adenopathy, and inflamed or purulent tonsils a prescription was more likely to be written. An enzyme immunoassay rapid test was evaluated as a means of rationalizing prescribing. Among 23 general practitioners and 250 patients the sensitivity of the test was 63% and the specificity 91.7% compared with 74% and 58% for clinical assessment alone. Test results rarely caused previous prescribing decisions (34 [corrected] (13%) episodes) to be altered. We suggest that the time is not ripe for the use of the enzyme immunoassay rapid test on a wide scale in the routine assessment of sore throats.
Burke
P
P
Department of Primary Medical Care, University of Southampton, Aldermoor Health Centre.
Bain
J
J
Lowes
A
A
Athersuch
R
R
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001431:Bacteriological Techniques; D011307:Drug Prescriptions; D004739:England; D005194:Family Practice; D006801:Humans; D007124:Immunoenzyme Techniques; D010612:Pharyngitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D010818:Practice Patterns, Physicians'; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis; D013290:Streptococcal Infections / Q000175:diagnosis
D000900:Anti-Bacterial Agents; D011933:Reagent Kits, Diagnostic