Conclusion
sore throat, pharyngitis
SORE THROAT, PHARYNGITIS
Apparently, neither the implementation of the DEGAM-guideline nor the modified guideline with a targeted rapid test for GAS resulted in fewer antibiotic prescriptions for sore throat.Application of the Centor or McIsaac score as proposed in the DEGAM-guideline did not lower prescriptions for sore throat. Given the low and heterogeneous prevalence of GAS and the low specificity of the scores in our study, an approach based on scores will apparently overestimate the frequency of GAS pharyngitis by a factor of 3 to 4.In the rapid test group there were, however, significantly more patients with high scores than in the guideline group. Adjustment resulted in fewer antibiotic prescriptions in the rapid test group compared to the group using only scores, despite GPs’ low adherence to negative RADTs. In view of the scepticism of physicians towards negative test results and the poor quality of the rapid test in daily practice, we suggest to explore the effects of point-of-care tests for GAS in studies focussing on training of practices and adherence of GPs to negative results. This training should put more emphasis than in the present study on information on GAS carrier status, the natural course of a sore throat and the expected benefits and disadvantages from antibiotic treatment.