Appropriate Antibiotic Use for Acute Pharyngitis

Sjoerd Zwart; Alfred Sachs

doi:10.7326/0003-4819-136-8-200204160-00018

Letters |16 April 2002

Appropriate Antibiotic Use for Acute Pharyngitis

Sjoerd Zwart, MD, PhD; Alfred Sachs, MD, PhD

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TO THE EDITOR:

We congratulate the Centers for Disease Control and Prevention, the American Academy of Family Physicians, and the American College of Physicians–American Society of Internal Medicine for their clear position paper on antibiotic use for acute pharyngitis in adults (1). These honorable organizations found a good balance between the risks for untreated group A β-hemolytic streptococcal pharyngitis and the risks posed by unnecessary use of antibiotics (side effects, microbial resistance, medicalization).

To our surprise, one recommended treatment strategy appeared to be almost identical to the guidelines in the Netherlands: to refrain from any microbiological test and to limit antibiotic therapy to patients with three or four of the so-called Centor criteria. This suggests that a traditionally strong microbe-oriented approach is gradually shifting toward a more patient-oriented approach. One explanation for this change could be that in many western communities, prevention of acute rheumatic fever is no longer the main reason to administer penicillin because of the low incidence of the condition.

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2002 American College of Physicians

Letters |16 April 2002

Appropriate Antibiotic Use for Acute Pharyngitis

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Letters |16 April 2002

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