Management of children with acute pharyngitis: a decision analysis.

Abstract

For children with at least a 40% chance of harboring streptococci and a duration of complaints of less than 2 days before starting treatment, diagnostic testing and prescription of oral penicillin appear to be the best choice of initial management. The rapid latex agglutination test is more effective than the throat culture, because prompt penicillin treatment after a positive test result may shorten the duration of pharyngitis in infected children. High rates of acute rheumatic fever (over 5 X 10(-4] and low medication compliance change the best strategy to agglutination test with intramuscular administration of penicillin.