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Most Clinicians Don't Follow Pharyngitis Guidelines

Antibiotics over-prescribed to low-risk patients

MONDAY, July 10 (HealthDay News) -- In almost two-thirds of primary care office visits for pharyngitis, health care practitioners sidestep established guidelines, usually by testing or prescribing antibiotics to patients at low risk of streptococcal pharyngitis, according to a report in the July 10 issue of the Archives of Internal Medicine.

Jeffrey A. Linder, M.D., of Brigham and Women's Hospital in Boston, and colleagues investigated treatment strategies used during 2,097 visits by adults with pharyngitis to Boston-area clinics.

The researchers found that clinicians followed American College of Physicians' strategy guidelines in 12 percent of visits, and American College of Physicians' and Infectious Diseases Society of America's testing guidelines in 30 percent of visits. But clinicians followed no strategy in 66 percent of visits, the researchers report.

"The major problem in the testing and treatment of adults with pharyngitis is not which guideline to follow, but that clinicians usually fail to follow any guideline," the authors write.

In an editorial, Robert M. Centor, M.D., of the University of Alabama School of Medicine in Birmingham, and a colleague write that "adult pharyngitis deserves a coordinated approach. We can greatly decrease antibiotic use if we would focus on withholding both testing and antibiotic treatment from those patients who have no clinical indication for these strategies."

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