Patients acutely ill with suspected streptococcal pharyngitis were treated with penicillin immediately in a general practice office. Patients so treated showed a response 24 hours sooner than those whose treatment was delayed for results of bacterial culture. This was true of both culture-positive and culture-negative cases, although to a lesser extent in the latter. The advantage of decreased morbidity for one day, together with the identification of patients with possible false-negative throat cultures, outweighs the theoretical disadvantage of penicillin reactions with early therapy. Because upper respiratory tract infection and acute pharyngitis are the most common acute illnesses seen in a primary practice, they represent an important population for management by nurse practitioners. Clinical and bacteriological diagnosis of streptococcal pharyngitis by nurse practitioners in this study were comparable in accuracy to that of a physician.
Merenstein JH, Rogers KD. Streptococcal Pharyngitis: Early Treatment and Management by Nurse Practitioners. JAMA. 1974;227(11):1278–1282. doi:10.1001/jama.1974.03230240036021
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