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June 8, 1984

Use of Throat Cultures

Author Affiliations

Meharry Medical College Nashville, Tenn

JAMA. 1984;251(22):2929. doi:10.1001/jama.1984.03340460019013

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To the Editor.—  I read with interest the article by Holmberg and Faich concerning throat culture practices in a recent issue of The Journal. I agree with the authors that the misuse of throat cultures is disheartening; however, I would add a cautionary note to their conclusion that "promotion of throat culturing by public health laboratories should be reconsidered."It is true that acute rheumatic fever is not, today, much of a public health problem. The proportion of its declining incidence, owing to improved nutrition and living standards, to widespread antibiotic use, or to decreased rheumatogenicity of group A streptococci, remains a cause for debate. Few would debate, however, that a weakening in surveillance and treatment standards would most probably result in a reversal in the incidence rate of acute rheumatic fever. Therefore, for that proportion of physicians who do use throat cultures correctly and for that even larger proportion