Pharyngitis management: defining the controversy

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



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


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.

DOI of Published Version



J Gen Intern Med. 2007 Jan;22(1):127-30. Link to article on publisher's site

Journal/Book/Conference Title

Journal of general internal medicine

PubMed ID


Related Resources

Link to Article in PubMed