Continuing Medical Education (CME)

Pharyngitis in Children and Adults [2006 update]

Introduction to this self-study CME activity

Purpose

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.

Audience

This self-study activity on pharyngitis in children and adults is appropriate for all primary care clinicians. 

Authors

Team Leader
	Terrance P. Murphy, MD Pediatrics
Team Members
	R.Van Harrison, PhD Medical Education Annissa J. Hammoud, MD Internal Medicine-Pediatrics Gary Yen, MD Family Medicine
Consultants
	R. Alexander Blackwood, MD, PhD Pediatric Infectious Diseases John R. Crump, MD General Internal Medicine
Author Disclosures
	Neither the members of the members of guideline team nor the consultants have relationships with commercial companies whose products are discussed in this guideline.

Other Acknowledgements

UMHS Guidelines Oversight Team: William E. Chavey, MD R. Van Harrison, PhD Connie J. Standiford, MD Literature search services: Taubman Medical Library Production of Internet format and web   site maintenance: Ellen Patrick-Dunlavey, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was released in October 2006, with credit available through September 2009. The activity was reviewed for currency of content in July 2009 and availability of credit extended through September 2012.

Method of Participation

1. View the web pages. You may print the self-study text to read off-line.
2. Complete the on-line learning assessment test with a score of 70% or higher.  After you initially take the test, the test will be immediately electronically scored. 
   If fewer than 70% of the questions are answered correctly, the questions that were not answered correctly will be noted in red.  Review the CME content related to those topics and retake the test.
   If 70% or more of the questions are answered correctly, the correct and incorrect answers for all questions will be shown along with explanations of the basis for the correct answer.  The link to register and receive credit is shown at the end of the items and explanations. 
3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
4. Print the certificate of participation for your personal records.

 

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