a medical newspaper from SLACK Incorporated New guidelines recommended for group A streptococcal pharyngitis A throat culture should be done to back up a negative rapid test; penicillin is still first-line treatment. by Alyson Hendrickson Wentz [Testing] [Penicillin V] [Your turn] December 1997 - SAN FRANCISCO - New practice guidelines for the diagnosis and management of group A streptococcal pharyngitis were presented here at a recent meeting of the Infectious Diseases Society of America. "Before we set the guidelines, we needed to determine our rationale for treating group A strep pharyngitis," said Alan L. Bisno MD, University of Miami and the VA Medical Center in Miami, chair of the committee that developed the guidelines. The rationale was:
- to prevent rheumatic fever; to prevent suppurative complications; to achieve rapid abatement of clinical symptoms; to protect close contacts of people with streptococcal infections from contracting the infection; and to facilitate the return of the patient to work or school.
The committee also recognized that group A streptococci (GAS) are only responsible for a minority of cases of acute pharyngitis - accounting for about 20% of cases in children. About 5% of these cases may be due to other bacteria, while another 40% to 45% are due to viruses. Approximately 5% are due to other organisms and in 30% to 40% of cases there is no etiologic diagnosis.
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