Managing sore throat: theory versus practice.
The authors address the reliability of clinical impression in the management of sore throat. Five primary care family physicians in rural Ontario examined 222 patients with sore throats. The clinical impression of either Group A β-hemolytic streptococcal (GABHS) or non-GABHS pharyngitis was recorded and throat cultures were ordered in each case. The physicians predicted that 50% of the cultures would be positive for GABHS, whereas only 13.5% actually had positive results. The initial clinical diagnosis of "strep throat" was correct only one in five times. Without cultures, at least 112 patients would have been treated with antibiotics, 87 unnecessarily. The authors conclude that the clinical prediction of GABHS is inaccurate and can lead to unnecessary use of antibiotics.
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J Clin Microbiol. 1985 Feb;21(2):258-9
3882750
Pediatr Infect Dis. 1985 Nov-Dec;4(6):647-50
3909119
Am J Dis Child. 1977 May;131(5):514-7
855837
Pediatr Infect Dis. 1984 Jan-Feb;3(1):10-3
6366769
Can Med Assoc J. 1985 Apr 1;132(7):755-60
3884119
Ann Intern Med. 1986 Dec;105(6):892-9
3535604
J Pediatr. 1986 Mar;108(3):347-51
3512807
J Pediatr. 1984 Nov;105(5):702-5
6389805
J Fam Pract. 1986 Sep;23(3):215-9
3528381
J Pediatr. 1985 Jun;106(6):870-5
3923180
J Pediatr. 1985 May;106(5):781-3
3889250
Emerg Med Clin North Am. 1987 May;5(2):335-51
3325277
J Pediatr. 1954 Jun;44(6):670-3
13163806
JAMA. 1983 Nov 4;250(17):2307-12
6355522
J Clin Microbiol. 1985 Mar;21(3):467-9
3884659
Diagn Microbiol Infect Dis. 1985 Nov;3(6 Suppl):39S-49S
3905232
J Clin Microbiol. 1984 Jul;20(1):12-4
6378963
J Clin Microbiol. 1985 Aug;22(2):145-8
3897261
Diagn Microbiol Infect Dis. 1986 Mar;4(3 Suppl):5S-15S
3516547
JAMA. 1985 Mar 1;253(9):1271-4
3918190
J Clin Microbiol. 1985 Mar;21(3):395-8
3884656
JAMA. 1974 Mar 18;227(11):1278-82
4405975