[Revision of the Dutch College of General Practitioners practice guideline 'Acute sore throat'].
The aim of a diagnostic work-up in patients with acute sore throat is to exclude serious causes of tonsillitis and, in cases of a pharyngotonsillitis, to assess the degree of illness and the risk of complications. A diagnostic work-up aimed at the distinction between a viral or bacterial cause of pharyngotonsillitis does not determine initial treatment policy. Pharyngotonsillitis usually has a benign natural course; patient information and analgesia are usually sufficient treatment. Complications of an infection with group A streptococci are rare; diagnostic work-up for this bacterial cause is, therefore, not recommended. Antibiotics are only useful in cases of severe pharyngotonsillitis, increased risk of complications or a peritonsillar infiltration. The antibiotic of choice is a narrow spectrum penicillin; however, amoxicillin/clavulanate is indicated in patients with peritonsillar infiltration. If there is discrepancy in adults between the severity of symptoms and findings on physical examination, the possibility of epiglottitis should be considered.
Nederlands Huisartsen Genootschap, afdeling Richtlijnontwikkeling en Wetenschap, Utrecht.
Egbert
E
de Jongh
Wim
W
Opstelten
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005194:Family Practice / Q000592:standards; D058005:General Practitioners / Q000592:standards; D006801:Humans; D009426:Netherlands; D059408:Pain Management; D010612:Pharyngitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*
D000900:Anti-Bacterial Agents