Trial of prescribing strategies for sore throat

EDITOR—We agree with Little et al that the symptom sore throat is one of the most common presenting complaints in primary care and that there is a tendency to overprescribe antibiotics.1 We do not, however, agree with the second key message of their paper, which states that complications of sore throat are rare. In any otolaryngology department the symptom sore throat accounts for a considerable number of urgent admissions. In our department in the past six months, 340 emergency admissions were recorded. Among these we identified 70 in which sore throat was the primary complaint. This means that there were an average of 2.69 admissions a week for this symptom. These patients are usually ill with high temperature, dysphagia, or a complication that has developed because of either lack of treatment or an insufficient or inadequate dose of antibiotics. They then require intensive intravenous antibiotic treatment, management of fluid balance, and sometimes surgical …