[Guidelines for diagnosis and treatment of sore throat].
BACKGROUND
Available guidelines for the diagnosis and treatment of sore throat give conflicting recommendations. Our aim was to develop evidence-based guidelines.


METHODS
We searched The Cochrane Library, Medline and other sources for systematic reviews and other evidence that met explicit inclusion criteria for all of the relevant options and outcomes we identified. The validity of included studies was assessed. Draft recommendations based on assessment of this evidence were widely circulated and discussed in focus groups with patients and physician assistants.


RESULTS
Throat infections are self-limiting and complications rare. Penicillin shortens the duration of symptoms in tonsillitis caused by beta-haemolytic streptococci and reduces the risk of complications. Penicillin has adverse effects and increases the risk of reinfections. Patients with sore throat should usually be treated without antibiotics. Visiting a physician is normally unnecessary. Antibiotics should be considered in serious cases or if the patient prefers this, but should only be prescribed for throat infections caused by beta-haemolytic streptococci. The diagnosis should be based on clinical criteria and a rapid antigen test in cases of doubt.


CONCLUSIONS
Benefits of antibiotics must be weighed against harms. Patients should be given good information and involved in decision/making if they want antibiotics.
Flottorp
S
S
Seksjon for helsetjenesteforskning Statens institutt for folkehelse, Oslo.
Oxman
A D
AD
Cooper
J G
JG
Hjortdahl
P
P
Sandberg
S
S
Vorland
L H
LH
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D018849:Controlled Clinical Trials as Topic; D019317:Evidence-Based Medicine; D006801:Humans; D015201:Meta-Analysis as Topic; D008954:Models, Biological; D010353:Patient Education as Topic; D010406:Penicillins / Q000008:administration & dosage / Q000009:adverse effects; D010612:Pharyngitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D014069:Tonsillitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents; D010406:Penicillins