Practice Observed

Rational decisions in managing sore throat: evaluation of a rapid test

Br Med J (Clin Res Ed) 1988; 296 doi: https://doi.org/10.1136/bmj.296.6637.1646 (Published 11 June 1988) Cite this as: Br Med J (Clin Res Ed) 1988;296:1646
  1. Peter Burke,
  2. John Bain,
  3. Andrew Lowes,
  4. Roger Athersuch

    Abstract

    Sixty nine general practitioners recorded what they had prescribed for a total of 1189 episodes of sore throat. Antibiotics were prescribed in 763 (64%) episodes and broad spectrum antibiotics in 161 (21%) of these. If there was dysphagia, hoarseness, cervical adenopathy, and inflamed or purulent tonsils a prescription was more likely to be written. An enzyme immunoassay rapid test was evaluated as a means of rationalising prescribing. Among 23 general practitioners and 250 patients the sensitivity of the test was 63% and the specificity 91·7% compared with 74% and 58% for clinical assessment alone. Test results rarely caused previous prescribing decisions (155 (13%) episodes) to be altered.

    We suggest that the time is not ripe for the use of the enzyme immunoassay rapid test on a wide scale in the routine assessment of sore throats.