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    Pharyngitis management: defining the controversy

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    Authors
    Centor, Robert Maccabbee
    Allison, Jeroan J.
    Cohen, Stuart James
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2007-03-14
    Keywords
    Anti-Bacterial Agents
    Antigens, Bacterial
    Drug Resistance, Bacterial
    Humans
    Pharyngitis
    Practice Guidelines as Topic
    Reagent Kits, Diagnostic
    Severity of Illness Index
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1007/s11606-006-0020-4
    Abstract
    Despite numerous controlled trials, clinical practice guidelines and cost-effective analyses, controversy persists regarding the appropriate management strategy for adult pharyngitis. In this perspective, we explore this controversy by comparing two competing clinical guidelines. Although the guidelines appear to make widely diverging recommendations, we show that the controversy centers on only a small proportion of patients: those presenting with severe pharyngitis. We examine recently published data to illustrate that this seemingly simple problem of strep throat remains a philosophical issue: should we give primacy to relieving acute time-limited symptoms, or should we emphasize the potential societal risk of antibiotic resistance? We accept potentially over treating a minority of adult pharyngitis patients with the most severe presentations to reduce suffering in an approximately equal number of patients who will have false negative test results if the test-and-treat strategy were used.
    Source
    J Gen Intern Med. 2007 Jan;22(1):127-30. Link to article on publisher's site
    DOI
    10.1007/s11606-006-0020-4
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47689
    PubMed ID
    17351852
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11606-006-0020-4
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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