Sore throat: It is probably the most common illness where antibiotics are misused. Although it accounts for 13% of all office visits, it has been found in various studies that only 8 to 20% of persons with a sore throat make a visit to a general practitioner and in the other 80-90% it cures spontaneously. Streptococcal sore throat is almost unknown in children below the age of 2 years and uncommon below 4 years.
Roughly 10 to 20% of persons who visit a clinic will have group A Streptococci (Strep throat) on throat culture and the other 80 to 90% with a sore throat will have a negative throat culture. But using clinical judgment alone will mean that 20 to 40% of this large group of persons will receive antibiotics. Randomized trials designed to show the benefits of antibiotics over aspirin or acetaminophen in adults with sore throat have shown either no difference or a modest benefit. In most trials, the fever difference was one degree Celsius or less and it was not determined if patients felt this as an important difference. A survey of physicians in 17 European countries reported that fever in patients with tonsillitis resolved itself in two or three days, with or without antibiotic treatment. Therefore routine use of antibacterials in cases of sore throat is often uncalled for.
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