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  • Delayed prescription worsens reported symptoms and increases antibiotic use compared with clinical score with or without rapid antigen testing in patients with sore throat

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Quality improvement
Randomised controlled trial
Delayed prescription worsens reported symptoms and increases antibiotic use compared with clinical score with or without rapid antigen testing in patients with sore throat
  1. Nader Shaikh,
  2. Judith M Martin
  1. Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to : Dr Nader Shaikh, Department of Pediatrics, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA; nader.shaikh{at}chp.edu

https://doi.org/10.1136/eb-2013-101648

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    Commentary on: Little P, Hobbs FD, Moore M, et al. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). BMJ 2013;347:f5806.

    Context

    Antibiotics are often prescribed for patients with acute sore throat to reduce the severity and/or duration of symptoms and to prevent rare complications. This study examined the impact of rapid antigen tests and clinical scoring methods on the symptom control and antibiotic use.

    Methods

    Patients ≥3 years old with acute pharyngitis were randomised to three pragmatic management strategies: ‘control group: delayed prescription’, ‘clinical score only’ and ‘clinical score + rapid antigen detection group’. Patients in the control group were advised to collect a prescription for antibiotics, but only if their symptoms failed to improve after 3–5 days of observation. Patients in the ‘clinical score only’ group were offered immediate antibiotics if they had a high score (≥4), no antibiotics if they had a low score (0 or 1) and …

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    Footnotes

    • Competing interests None.