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July 8, 1974

Prescription for "Sore Throat"

JAMA. 1974;229(2):137. doi:10.1001/jama.1974.03230400013003

To the Editor.—  A frequently encountered question asked by medical student preceptees and physicians new to the private clinical practice of medicine is: "Which patient with a sore throat should be treated with antibiotics and why?"We believe that type A β-streptococci should be identified or eliminated in the diagnosis of any acute sore throat by culture, and we agree that office nurses can do this effectively, provided that the technician can report β-hemolysis inhibited by bacitracin, and morphological identification of streptococci from stained smears from the hemolytic colonies. To depend on hemolysis alone is very precarious.Anyone who has a really sore throat should have a pharyngeal culture taken. Even in infectious mononucleosis, up to 25% superinfection by hemolytic streptococci has been reported.Our office nurses could prescribe an effective antibiotic for an appropriate period of time if they were called upon to do so in most cases. But