Jan Matthys, MD; Marc De Meyere, MD; An De Sutter, MD
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=L15-0188.
Matthys J., De Meyere M., De Sutter A.; Fusobacterium-Positive and Streptococcal-Positive Pharyngitis. Ann Intern Med. 2015;162:876. doi: 10.7326/L15-5099
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Published: Ann Intern Med. 2015;162(12):876.
TO THE EDITOR:
We thank Centor and colleagues (1) for their interesting and important new data on causes of pharyngitis. As authors of the Belgian guideline on acute sore throat (2), we agree with Linder's editorial (3), which argues that these new findings on Fusobacterium necrophorum do not necessitate reconsideration in U.S. guidelines.
Centor and colleagues' proposition implies more testing and more antibiotics but is not evidence-based. Even a positive culture for F. necrophorum is not definitive proof of infection, and arguments are lacking that treating infection with this organism with antibiotics decreases symptoms or prevents the Lemierre syndrome (3). We know that a positive culture for group A β-hemolytic streptococcus is not definitive evidence of infection but may indicate carriership; this may also be true for a positive culture for F. necrophorum.
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