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Purpose, Audience, Authors, and Acknowledgements
Pharyngitis is a common presenting complaint in primary care. While viruses are the most common cause, group A beta hemolytic Streptococcus infection (GABHS), ABHS can be the cause in children (15%–30%) and adults (5%–10%). The primary reason to identify and treat GABHS is to decrease the risk of acute rheumatic fever. A growing concern is the indiscriminate use of antibiotics, which may increase the incidence of allergic reactions to antiobitics and the emergence of resistant strains of pathogenic bacteria.
This CME activity helps clinicians estimate the probability of GABHS based on the symptoms of the patient. The probability is used to identify a cost effective strategy for diagnosing and treating GABHS for that patient. Some of the key points are:
- Probability scores can guide decisions regarding no diagnostic testing or no testing.
- Test for strep! Reduce the indiscriminate use of antibiotics for those who will not benefit.
- In patients ≥ 16 years of age, if a rapid strep screen is negative it is acceptable NOT to send a confirming throat culture. However, in patients < 16 a confirming throat culture should be sent if the rapid screen is negative.
- Recommended medications and their costs have been updated.
- Amoxicillin 750 mg (250 mg 3 tabs) as a single daily dose for 10 days is as effective as Pen VK given t.i.d. for 10 days.
- new table lists options for treating patients with symptomatic, recurrent GABHS pharyngitis.
This self-study activity on pharyngitis in children and adults is appropriate for all primary care clinicians.
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Team Leader |
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Terrance P. Murphy, MD
Pediatrics |
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Team Members |
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R.Van Harrison, PhD
Medical Education
Annissa J. Hammoud, MD
Internal Medicine-Pediatrics |
Gary Yen, MD
Family Medicine |
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| Consultants |
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R. Alexander Blackwood, MD, PhD
Pediatric Infectious Diseases |
John R. Crump, MD
General Internal Medicine |
Author Disclosures |
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Neither the members of the members of guideline team nor the consultants have relationships with commercial companies whose products are discussed in this guideline. |
UMHS Guidelines Oversight Team: |
Connie Standiford, MD
William Chavey, MD
Van Harrison, PhD |
Literature search services: |
Taubman Medical Library |
Production of Internet format of guideline: |
Ellen Patrick-Dunlavey |
Web site design and maintenance: |
Murat Yashin |
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