title: Common Questions About Streptococcal Pharyngitis.
abstract: Group A beta-hemolytic streptococcal (GABHS) infection causes 15% to 30% of sore throats in children and 5% to 15% in adults, and is more common in the late winter and early spring. The strongest independent predictors of GABHS pharyngitis are patient age of five to 15 years, absence of cough, tender anterior cervical adenopathy, tonsillar exudates, and fever. To diagnose GABHS pharyngitis, a rapid antigen detection test should be ordered in patients with a modified Centor or FeverPAIN score of 2 or 3. First-line treatment for GABHS pharyngitis includes a 10-day course of penicillin or amoxicillin. Patients allergic to penicillin can be treated with firstgeneration cephalosporins, clindamycin, or macrolide antibiotics. Nonsteroidal anti-inflammatory drugs are more effective than acetaminophen and placebo for treatment of fever and pain associated with GABHS pharyngitis; medicated throat lozenges used every two hours are also effective. Corticosteroids provide only a small reduction in the duration of symptoms and should not be used routinely.
authors.affiliation: Memorial Family Medicine Residency, Sugar Land, TX, USA.
authors.forename: Monica G
authors.initials: MG
authors.lastname: Kalra
authors.affiliation: Envoy Hospice and Brookdale Hospice, Fort Worth, TX, USA.
authors.forename: Kim E
authors.initials: KE
authors.lastname: Higgins
authors.affiliation: Memorial Family Medicine Residency, Sugar Land, TX, USA.
authors.forename: Evan D
authors.initials: ED
authors.lastname: Perez
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000942:Antigens, Bacterial; D005122:Exudates and Transudates; D005334:Fever / Q000209:etiology; D006801:Humans; D000072281:Lymphadenopathy / Q000209:etiology; D009333:Neck; D059408:Pain Management; D010406:Penicillins / Q000627:therapeutic use; D010612:Pharyngitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D013297:Streptococcus pyogenes
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000942:Antigens, Bacterial; D010406:Penicillins; D000658:Amoxicillin