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August 16, 1985

Diagnosis and Treatment of Streptococcal Pharyngitis

Author Affiliations

Multicare Medical Center Tacoma, Wash

JAMA. 1985;254(7):908. doi:10.1001/jama.1985.03360070045010

To the Editor.—  The report of Krober et al1 and the editorial by Fulginiti2 in the March 1 issue of The Journal regarding the treatment of streptococcal pharyngitis failed to address the importance of diagnostic methodologies for the identification of Streptococcus pyogenes (Lancefield group A streptococci). Krober et al state that "throat swabs were... plated immediately onto 5% sheep blood agar and streaked. They were then incubated in 5% CO2 at 35 °C for 18 to 24 hours. At this time, they were examined for the presence of group A β-hemolytic streptococci (GABHS)." They state that bacitracin disks were used to differentiate GABHS from non-GABHS, referencing the work of Facklam et al.3I interpret the method described by Krober et al to be that the bacitracin disk was placed on the primary plate and after 18 to 24 hours of incubation, GABHS were identified as β-hemolytic colonies