Fast Five Quiz: Sore Throat

Arlen D. Meyers, MD, MBA


November 06, 2019

According to IDSA updated guidelines, a positive rapid antigen detection test result confirms GAS pharyngitis. A backup culture is recommended in children and adolescents with negative test results; however, a backup culture is not routinely necessary in adults because the incidence of the illness is low and the risk for subsequent rheumatic fever in adults is small. According to the IDSA guidelines, antistreptococcal antibody titers are not recommended in the routine diagnosis of acute pharyngitis.

The guidelines also recommend that GAS pharyngitis should be treated with an antibiotic such as penicillin or amoxicillin, usually for 10 days. Penicillin or amoxicillin is recommended due to the narrow spectrum of activity, few adverse effects, and cost. Alternative antibiotics for patients with penicillin allergy include a first-generation cephalosporin, clindamycin, clarithromycin, or azithromycin.

Adjunctive therapy with an antipyretic or analgesic may be considered for patients with moderate to severe symptoms or to control a high fever. Aspirin is not recommended in children, and adjunctive corticosteroids are not recommended in the treatment of GAS pharyngitis.

Read more about the treatment of pharyngitis.


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