title: Primary care management of group A streptococcal pharyngitis in Northland.
abstract: BACKGROUND
  Reducing the rate of acute rheumatic fever nationally by two-thirds by 2017 is a New Zealand Ministry of Health priority. Northland District Health Board (DHB) has high rates of rheumatic fever, disproportionately impacting on Maori children and young people. School-based programmes and general practice both contribute to rheumatic fever prevention in detecting and appropriately treating group A streptococcal (GAS) pharyngitis.
  
  
  OBJECTIVE
  The aim of this study was to assess adherence by general practitioners and school-based sore throat programmes to national guidelines for the management of GAS pharyngitis in Northland.
  
  
  METHODS
  Laboratory and pharmaceutical data were obtained for children and young people aged 3-20 years who had GAS positive throat swabs in Northland laboratory services between 1 April and 31 July 2012. Data were analysed separately for general practice and the school programmes for rheumatic fever prevention.
  
  
  RESULTS
  One in five of those children presenting to general practice with a positive throat swab and complete prescription data did not receive treatment according to national guidelines, while appropriate treatment was offered to more than 98% of children accessing school-based programmes. A significant proportion of those seen in general practice received antibiotics not recommended by guidelines, an inadequate length of treatment or no prescription. There were no significant differences in the management of Maori and non-Maori children.
  
  
  CONCLUSIONS
  There is room for improvement in general practice management of GAS pharyngitis in Northland. School-based management of sore throat provides high-quality management for children at high risk of rheumatic fever.
authors.affiliation: Public and Population Health, Northland District Health Board, Whangarei, New Zealand.
authors.forename: Anil
authors.initials: A
authors.lastname: Shetty
authors.affiliation: Public and Population Health Unit, Northland District Health Board, PB 9742, Whangarei 0148, New Zealand. clair.mills@northlanddhb.org.nz.
authors.forename: Clair
authors.initials: C
authors.lastname: Mills
authors.affiliation: Department of General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand.
authors.forename: Kyle
authors.initials: K
authors.lastname: Eggleton
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D009520:New Zealand; D010406:Penicillins / Q000627:therapeutic use*; D010612:Pharyngitis / Q000188:drug therapy* / Q000208:ethnology / Q000382:microbiology; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D012213:Rheumatic Fever / Q000208:ethnology / Q000517:prevention & control*; D013297:Streptococcus pyogenes
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins