Infection of the throat

Pharyngitis is usually viral but the more serious cases may be caused by Streptococcus pyogenes (Group A) which is always sensitive to benzylpenicillin. Unfortunately, streptococcal sore throats cannot be clinically differentiated from non-streptococcal with any certainty. Prevention of complications is more important than relief of the symptoms which seldom last long. There is no general agreement whether chemotherapy should be employed in mild sporadic sore throat and expert reviews on the subject reflect the resulting diversity of clinical views.1,2-3 The disease usually subsides in a few days, septic complications are uncommon and rheumatic fever rarely follows. It is reasonable to withhold penicillin unless streptococci are cultured or the patient develops a high fever. Severe sporadic or epidemic sore throat is likely to be strepto-

1 Cooper R J, Hoffman J R, Bartlett J G et al 2001 Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Annals of Internal Medicine 134: 506.

2 Del Mar C B, Glasziou P P, Spinks A B 2001 Antibiotics for sore throat (Cochrane Review). The Cochrane Library 2. Oxford: Update Software.

3 Thomas M, Del Mar C, Glasziou P 2000 How effective are treatments other than antibiotics for acute sore throat? British Journal of General Practice 50:817.

NFECTION OF THE BRONCHI, LUNGS AND PLEURA

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