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June 8, 1984

Use of Throat Cultures

Author Affiliations

Willimantic, Conn

JAMA. 1984;251(22):2929. doi:10.1001/jama.1984.03340460019012

To the Editor.—  I was disheartened by the report by Holmberg and Faich1 showing that 40% of the primary care physicians surveyed in Rhode Island in 1980 continued antibiotic therapy for ten days despite the presence of a negative streptococcal culture.However, I was further dismayed by their conclusion that casts doubt on the value of examining a patient for streptococcal pharyngitis and treating that person when the culture is positive. While the incidence of rheumatic fever is indeed dropping and quite low at this time, exact reasons for this are unclear. The implication that it would be better to treat all sore throats with penicillin or to treat none at all does not seem rational.Rather, it seems clear that a large number of primary care physicians in Rhode Island (and most likely elsewhere also) need to be educated in the proper management of pharyngitis. While not proper,