Rational decisions in managing sore throat: evaluation of a rapid test

Abstract

Sixty nine general practitioners recorded what they had prescribed for a total of 1189 episodes of sore throat. Antibiotics were prescribed in 763 (64%) episodes and broad spectrum antibiotics in 161 (21%) of these. If there was dysphagia, hoarseness, cervical adenopathy, and inflamed or purulent tonsils a prescription was more likely to be written. An enzyme immunoassay rapid test was evaluated as a means of rationalising prescribing. Among 23 general practitioners and 250 patients the sensitivity of the test was 63% and the specificity 91·7% compared with 74% and 58% for clinical assessment alone. Test results rarely caused previous prescribing decisions (155 (13%) episodes) to be altered. We suggest that the time is not ripe for the use of the enzyme immunoassay rapid test on a wide scale in the routine assessment of sore throats.