Randomization into three study arms
throat
STREP
The practices were randomized by Jürgen Hedderich with the computer program BiAS [
Guideline group (GL-group): The GPs were instructed to follow the DEGAM guideline 2009 as outlined in the introduction.Guideline and targeted rapid antigen detection test group (GL-RADT-group): GPs were to proceed as in the GL-group, but should take a throat swab for a RADT in all patients with a Centor or McIsaac score ≥ 3, and offer an immediate or delayed antibiotic therapy only to patients with a positive RADT or, in case of a negative RADT, if GAS could be shown in a culture initiated by the practice, independent of the study throat swab (see below). We chose the Alere™ TestPack + Plus Strep A test with OBC, produced by Inverness Medical Innovations until 2010, because of good in vitro performance and ease of use [Usual care group (UC-group): GPs should follow their normal routine.The guidelines in the GL- and GL-RADT-group provided recommendations, but ultimately the GPs themselves decided on the medical treatment.