title: Recommendations for management of acute pharyngitis in adults.
abstract: Acute pharyngitis in adults is one of the most common infectious diseases seen in general practitioners' consultations. Viral aetiology is the most common. Among bacterial causes, the main agent is Streptococcus pyogenes or group A β-haemolytic streptococcus (GABHS), which causes 5%-30% of the episodes. In the diagnostic process, clinical assessment scales can help clinicians to better predict suspected bacterial aetiology by selecting patients who should undergo a rapid antigen detection test. If these techniques are not performed, an overdiagnosis of streptococcal pharyngitis often occurs, resulting in unnecessary prescriptions of antibiotics, most of which are broad spectrum. Consequently, management algorithms that include the use of predictive clinical rules and rapid tests have been set up. The aim of the treatment is speeding up symptom resolution, reducing the contagious time span and preventing local suppurative and non-suppurative complications. Penicillin and amoxicillin are the antibiotics of choice for the treatment of pharyngitis. The association of amoxicillin and clavulanate is not indicated as the initial treatment of acute infection. Neither are macrolides indicated as first-line therapy; they should be reserved for patients allergic to penicillin. The appropriate diagnosis of bacterial pharyngitis and proper use of antibiotics based on the scientific evidence available are crucial. Using management algorithms can be helpful in identifying and screening the cases that do not require antibiotic therapy.
authors.affiliation: Centro de Atención Primaria La Marina, Barcelona, España; Sociedad Española de Medicina de Familia y Comunitaria (SemFYC), España.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Cots
authors.affiliation: Servicio de Microbiología, Hospital Universitario de Getafe, Getafe, Madrid, España; Grupo de Estudio de la Infección en Atención Primaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIAP-SEIMC), España.
authors.forename: Juan-Ignacio
authors.initials: JI
authors.lastname: Alós
authors.affiliation: Centro de Salud de Valdefierro, Zaragoza, España; Sociedad Española de Médicos Generales y de Familia (SEMG), España.
authors.forename: Mario
authors.initials: M
authors.lastname: Bárcena
authors.affiliation: Farmacia Arizcun, Sant Pere de Ribes, Barcelona, España; Sociedad Española de Farmacia Comunitaria (SEFAC), España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Boleda
authors.affiliation: Centro de Salud Algorta-Bidezábal, Getxo, Vizcaya, España; Sociedad Española de Médicos de Atención Primaria (SEMERGEN), España.
authors.forename: José L
authors.initials: JL
authors.lastname: Cañada
authors.affiliation: Servicio de Otorrinolaringología, Hospital Comarcal de Hellín, Hellín, Albacete, España; Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial (SEORL-PCF), España.
authors.forename: Niceto
authors.initials: N
authors.lastname: Gómez
authors.affiliation: Farmacia Caelles, Reus, Tarragona, España; Sociedad Española de Farmacia Comunitaria (SEFAC), España.
authors.forename: Ana
authors.initials: A
authors.lastname: Mendoza
authors.affiliation: Servicio de Otorrinolaringología, Hospital Clínic, Barcelona, España; Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial (SEORL-PCF), España. Electronic address: ivila@clinic.ub.es.
authors.forename: Isabel
authors.initials: I
authors.lastname: Vilaseca
authors.affiliation: Centro de Salud Jaume I, Tarragona, España; Sociedad Española de Medicina de Familia y Comunitaria (SemFYC), España.
authors.forename: Carles
authors.initials: C
authors.lastname: Llor
mesh_terms: D000208:Acute Disease; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D057970:Inappropriate Prescribing; D018942:Macrolides / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D010612:Pharyngitis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013297:Streptococcus pyogenes
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D010406:Penicillins; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin
keywords: Adult; Adulto; Antibiotics; Antibióticos; Diagnosis; Diagnóstico; Faringoamigdalitis aguda; Pharyngitis; Streptococcus pyogenes; Tratamiento; Treatment