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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
Grossman N. Use of Throat Cultures. JAMA. 1984;251(22):2929. doi:10.1001/jama.1984.03340460019013