RECONSIDERING SORE THROATS .1. PROBLEMS WITH CURRENT CLINICAL-PRACTICE

OBJECTIVE To provide evidence-based answers to clinical questions pose d by family physicians about Group A streptococcus pharyngitis and to further understanding of why management is controversial. QUALITY OF E VIDENCE Evidence from randomized trials was not found for most questio ns. The most critical information came from high-quality community pre valence studies and criterion standard studies of physician clinical j udgment. MAIN FINDINGS Expert recommendations for physician management are not likely to help prevent rheumatic fever, as most people with s ore throats do not seek medical care. Current clinical practices resul t in overuse of antibiotics because accuracy of clinical judgment is l imited. CONCLUSIONS Costs associated with visits for upper respiratory infections as well as increasing antibiotic resistance necessitate re considering the current clinical approach. An alternative management s trategy is presented in part 2.