Doctors want you to say ‘ah’ before getting antibiotics for that sore throat

A study evaluating five ways to manage pharyngitis, or sore throat, found that prescribing potent germ killers -- without testing to see if the cause is a bacteria -- is the least effective and most costly strategy.

Researchers at Harvard Medical School and the Medical College of Wisconsin analyzed strep throat studies published in the 1990s. They found that testing before treatment was the most cost-effective strategy.

The old-fashioned throat culture, which requires at least a 24-hour wait for results, was only marginally ahead of the rapid in-office OIA (optical immunoassay) test. Combining the two tests was effective but expensive. Doing nothing but observing the patient for a few days to see if the sore throat went away was the least expensive option, but obviously not effective for patients who did have a strep infection.

Bypassing testing and going straight to antibiotics should occur only if a doctor thinks there’s at least a 70% chance that you have a bacterial infection, says senior author Dr. Mark D. Aronson, professor of medicine at Harvard and the Beth Israel Deaconess Medical Center in Boston. “But 90% of the time people don’t fit that description,” he says, “and yet 75% of them get antibiotics anyway.”

This study appeared in the July 15 issue of the Annals of Internal Medicine.

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Dianne Partie Lange