Intended for healthcare professionals

Primary Care

Penicillin for acute sore throat in children: randomised, double blind trial

BMJ 2003; 327 doi: (Published 04 December 2003) Cite this as: BMJ 2003;327:1324

Sore throats do not require antibiotics

The author's Sjoerd Zwart and colleagues are to be congrtulated for
such a nice paper.It has all the the hallmarks of a well designed and
concluded study which has been very nicely written up.It however has a few
short comings and the results need to be interpretted with a pinch of salt.

First off all the reason of exclusion of such a large group of children
was not clear.It would be nice to know the reasons and if they had
symptoms which in the eye of the treating clinician required use of
antibiotic. Secondly the distribution of the Group A streptococcal
infection in the three group was not mentioned which would influence the
deduction of the result of sequelae.Also the High incidence of sequelae in
the placebo group consdering that 61.5%(96/156) had Streptococcal A
infection i.e 23 children in placebo group of whom 8 had streptococcal
sequelae,which is 34.7% which considering the high incidence of carrier
rates in children may be considered higher than noramal.

In conclusion it can be said it is very well written paper which re-
affirms the fact that use of antibiotics in early sore throat is
unnecessary and a waste of resources but the debate is still open for late
severe cases with proven streptococcal A infection.

Competing interests:
None declared

Competing interests: No competing interests

08 December 2003
Mohammed Shamim Absar
SPR General surgery
Trafford General Hospital,Manchester