The validity of a sore throat score in family practice

McIsaac, Warren J.; Goel, Vivel; To, Teresa; Low**++, Donald E.
October 2000
CMAJ: Canadian Medical Association Journal;10/03/2000, Vol. 163 Issue 7, p811
Academic Journal
AbstractBackground: Reducing the number of antibiotic prescriptions given for common respiratory infections has been recommended as a way to limit bacterial resistance. This study assessed the validity of a previously published clinical score for the management of infections of the upper respiratory tract accompanied by sore throat. The study also examined the potential impact of this clinical score on the prescribing of antibiotics in community-based family practice.Methods: A total of 97 family physicians in 49 Ontario communities assessed 621 children and adults with a new infection of the upper respiratory tract accompanied by sore throat and recorded their prescribing decisions. A throat swab was obtained for culture. The sensitivity and specificity of the score approach in this population were compared with previously published results for patients seen at an academic family medicine centre. In addition, physicians' prescribing practices and their recommendations for obtaining throat swabs were compared with score-based recommendations.Results: Of the 621 cases of new upper respiratory tract infection and sore throat, information about prescriptions given was available for only 619; physicians prescribed antibiotics in 173 (27.9%) of these cases. Of the 173 prescriptions, 109 (63.0%) were given to patients with culture-negative results for group A Streptococcus. Using the score to determine management would have reduced prescriptions to culture-negative patients by 63.7% and overall antibiotic prescriptions by 52.3% (both p <0.01). Culturing of throat samples would have been reduced by 35.8% (p <0.01). There was no statistically significant difference in the sensitivity or specificity of the score approach between this community-based population (sensitivity 85.0%, specificity 92.1%) and an academic family medicine centre (sensitivity 83.1%, specificity 94.3%).Interpretation: An explicit clinical score approach to the management of patients presenting with...


Related Articles

  • Rational decisions in managing sore throat: evaluation of a rapid test. Burke, Peter; Bain, John; Lowes, Andrew; Athersuch, Roger // British Medical Journal (Clinical Research Edition);6/11/1988, Vol. 296 Issue 6637, p1646 

    Examines the efficacy of sore throat management. Prescriptions of antibiotics; Application of enzyme immunoassay rapid test for the investigation; Sensitivity of the test.

  • Antibiotic Prescribing by Pediatricians for Respiratory Tract Infection in Children. Arnold, Sandra R.; Allen, Upton D.; Al-Zahrani, Mohammed; Tan, Darrell H. S.; Wang, Elaine E. L. // Clinical Infectious Diseases;8/1/1999, Vol. 29 Issue 2, p312 

    Examines the antibiotic prescribing rates for viral respiratory tract infections (RTI) in children by pediatricians in Toronto, Ontario. Number of visits for each diagnosis and frequency of antibiotics prescribed for RTI by pediatricians; Proportion of antibiotic prescriptions for RTI by...

  • Editorial Response: Judicious Use of Antimicrobial Agents for Respiratory Tract Infections in Children--Why Are the Pediatricians in Toronto Doing So Well? Gerber, Michael A.; Marcy, S. Michael // Clinical Infectious Diseases;8/1/1999, Vol. 29 Issue 2, p318 

    Comments on the article of Sandra Arnold et al. in the August 1999 issue of 'Clinical Infectious Diseases' on the evaluation of antibiotic prescribing practices of 61 pediatricians for respiratory tract infection in Toronto, Canada. Factors that may lead physicians to overtreat viral...

  • Stanford offers WEB Course in Antibiotic Stewardship.  // Infectious Disease Alert;Jan2014, Vol. 33 Issue 4, p45 

    A description of the course "Antimicrobial Stewardship: Optimization of Antibiotic Practices" being offered by the division of Infectious Diseases in the Stanford University School of Medicine is presented.

  • Wide variation exists in antibiotic prescribing for Medicare patients based on geography, season. Walker, Tracey // Formulary;Nov2012, Vol. 47 Issue 11, p383 

    The article discusses research on Medicare Part D data which was published in the publication "Online First" from the "Archives of Internal Medicine". The research, which was conducted by Yuting Zhang and his colleagues at the University of Pittsburgh, found that there is a wide variation in...

  • Why Antibiotics Are Misused. Hough, Douglas E. // H&HN: Hospitals & Health Networks;Oct2014, Vol. 88 Issue 10, p16 

    No abstract available.

  • Letters to the Editor. Lin, Kenneth W.; DOERING, TRACEY; ZOOROB, ROGER; SIDANI, MOHAMAD A. // American Family Physician;2/15/2013, Vol. 87 Issue 4, p238 

    A letter to the editor is presented in response to the article "Antibiotic Use in Acute Respiratory Tract Infection" in the November 1, 2012 issue.

  • Antibiotic Use Declines Overall, While Use of Broad-Spectrum Increases. Elliott, William T. // Clinical Oncology Alert;Oct2010 Supplement, p1 

    The article discusses research on trends on the use of antibiotics for respiratory tract infections, which references a study by C. G. Grijalva et al, published in a 2009 issue of the "Journal of American Medical Association."

  • Antibiotic Use Declines Overall, While Use of Broad-Spectrum Increases. Elliott, William T. // Clinical Cardiology Alert;Oct2010 Clinical Briefs, p1 

    The article reports on the result of a study by C. G. Grijalva published in the 2009 issue of the "Journal of the American Medical Association (JAMA)," which shows a decrease in doctor-prescribed antibiotics for acute respiratory tract infections (ARTI).


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics