A comprehensive survey of physicians, laboratories, and hospital records in Rhode Island showed that more than 157,000 throat cultures for a population of 930,000 people were done in 1980. Eighty-seven percent of primary care physicians prescribed antibiotic therapy before culture results were known, and almost 40% continued antibiotic therapy for ten days regardless of culture results. The throat culture positivity rate for β-hemolytic Streptococcus was 17% statewide in 1980. Only three definite and seven possible cases of acute rheumatic fever were identified by hospital chart reviews and a physician survey covering the five years 1976 through 1980. Current throat culture practices probably have little influence on treatment of streptococcal pharyngitis and control of rheumatic fever in the state.
Holmberg SD, Faich GA. Streptococcal Pharyngitis and Acute Rheumatic Fever in Rhode Island. JAMA. 1983;250(17):2307-2312. doi:10.1001/jama.1983.03340170033024