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Cohort study
Identifying streptococcal throat infections in primary care: more guidance but uncertainty remains
  1. Anne G M Schilder1,2,3,
  2. Roderick P Venekamp2,3
  1. 1UCL ENT Clinical Trials Programme, Ear Institute, University College London, London, UK
  2. 2Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
  3. 3Department of Otorhinolaryngology, University Medical Center Utrecht, Utrecht, The Netherlands
  1. Correspondence to : Prof dr Anne G M Schilder
    UCL ENT Clinical Trials Programme, Ear Institute, University College London, UCL Rockefeller Building Room 233, 21 University Street, London WC1E 6DE, UK; a.schilder{at}

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Commentary on Little P, Hobbs FR, Mant D, et al. Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study. Br J Gen Pract 2012;62:787–94.


Acute pharyngitis is among the most common reasons for primary care visits.1 Although current evidence suggests that antibiotics have some beneficial effects on symptoms in patients suffering from acute sore throat, in particular in those with Lancefield group A β-haemolytic streptococcal (GABHS) infections, the absolute benefits are marginal, as almost 90% of treated and untreated patients are symptom free by 1 week.2 Criteria from the research of Centor et al3 are most commonly used to predict GABHS infection in patients suffering from acute sore throat. The use of these criteria, however, leads to high antibiotic prescription rates in particular because of their low specificity.4 Moreover, other Lancefield groups …

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