[Sore throat in general practice. Minimizing diagnosis--preventing superfluous use of antibiotics].
Sore throat usually is caused by viral pharyngitis, in about 15 to 30% by group A beta-haemolytic streptococci. Based on current concepts a guideline for the management in general practice is developed. If the typical symptoms of streptococcal pharyngo-tonsillitis are present--serious sore throat, fever more than 38.5 degrees C, purulent tonsillar exsudate, painful cervical lymphadenopathy, lack of cough or rhinorrhea--without any other diagnostic procedure penicillin is given for ten days. Only in cases of doubt throat swabs are taken for rapid diagnostic test and culture. The implementation of the guideline permits differentiation between viral pharyngitis and streptococcal tonsillitis by simple questions and physical examination and prevention of unnecessary diagnostics and antibiotic overuse.
Medizinische Poliklinik, Klinikum Innenstadt der LMU München. hbarwitz@t-online.de
H J
HJ
Barwitz
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006801:Humans; D010612:Pharyngitis / Q000188:drug therapy / Q000209:etiology*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000187:drug effects; D016896:Treatment Outcome; D014777:Virus Diseases / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents