Principles of Appropriate Antibiotic Use for Acute Pharyngitis in Adults
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Position Papers20 March 2001Principles of Appropriate Antibiotic Use for Acute Pharyngitis in AdultsVincenza Snow, MD, Christel Mottur-Pilson, PhD, Richelle J. Cooper, MD, MSHS, and Jerome R. Hoffman, MD, MA, for the American College of Physicians–American Society of Internal Medicine*Vincenza Snow, MD, Christel Mottur-Pilson, PhD, Richelle J. Cooper, MD, MSHS, and Jerome R. Hoffman, MD, MA, for the American College of Physicians–American Society of Internal Medicine*Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-6-200103200-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this guideline, we present the evidence and make specific recommendations on how clinicians can distinguish and diagnose pharyngitis caused by group A β-hemolytic streptococcus (GABHS). We also discuss when antibiotic use is beneficial and which antibiotics should be used. This guideline will not cover gonococcal pharyngitis and diphtheria, for which the appropriateness of immediate antibiotic treatment is well established. The numbers in square brackets are cross-references to the numbered sections in the accompanying background paper, "Principles of Appropriate Antibiotic Use for Acute Pharyngitis in Adults: Background," which is part 2 of this guideline (see pages 509-517).Acute PharyngitisAcute ... Author, Article, and Disclosure InformationAffiliations: *This paper, written by Vincenza Snow, MD, Christel Mottur-Pilson, PhD, Richelle J. Cooper, MD, MSHS, and Jerome R. Hoffman, MD, MA, was developed for the Clinical Efficacy Assessment Subcommittee: David C. Dale, MD (Chair); Patricia P. Barry, MD; William E. Golden, MD; Robert D. McCartney, MD; Keith W. Michl, MD; Allan R. Ronald, MD; Sean R. Tunis, MD; Kevin B. Weiss, MD; and Preston L. Winters, MD. Approved by the Board of Regents on 16 July 2000.Annals of Internal Medicine encourages readers to copy and distribute this paper, providing such distribution is not for profit. Commercial distribution is not permitted without the express permission of the publisher.Note: Clinical practice guidelines are "guides" only and may not apply to all patients and all clinical situations. Thus, they are not intended to override clinicians' clinical judgment. All clinical practice guidelines from the American College of Physicians–American Society of Internal Medicine are considered automatically withdrawn or invalid 5 years after publication or once an update has been issued.Grant Support: Dr. Cooper is supported in part by a National Research Service Award (F32 HS00134-01) from the Agency for Healthcare Research and Quality.Corresponding Author: Customer Service, American College of Physicians–American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106.Current Author Addresses: Drs. Snow and Mottur-Pilson: American College of Physicians–American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106.Drs. Cooper and Hoffman: Department of Emergency Medicine, University of California, Los Angeles, 924 Westwood Boulevard, Los Angeles, CA 90024. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAppropriate Use of Antibiotics: Pharyngitis Alan L. Bisno and Edward L. Kaplan Principles of Appropriate Antibiotic Use: Acute Pharyngitis Gene H. Stollerman Principles of Judicious Antibiotic Use: Acute Rhinosinusitis James R. 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A position statement from an expert panelClinical Mimics: An Emergency Medicine-Focused Review of Streptococcal Pharyngitis MimicsSore ThroatPharyngitisEvaluation of Rational Drug Use for Acute Pharyngitis Associated with the Incidence and Prevalence of the Disease at Two Community Health Centers in IndonesiaThe Management of Bacterial Infection-Associated GlomerulonephritisGuidelines for the Antibiotic Use in Adults with Acute Upper Respiratory Tract InfectionsA feasibility service evaluation of screening and treatment of group A streptococcal pharyngitis in community pharmaciesAppropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteriaPoint-Counterpoint: A Nucleic Acid Amplification Test for Streptococcus pyogenes Should Replace Antigen Detection and Culture for Detection of Bacterial PharyngitisDifferent antibiotic treatments for group A streptococcal pharyngitisScarlet fever: A not so typical exanthematous pharyngotonsillitis (based on 171 cases)Comparison of Clinical Findings and Rapid Streptococcal Antigen Detection Test in the Diagnosis of Group A Streptococcal (GAS) PharyngitisTranslating diagnostic assays from the laboratory to the clinic: analytical and clinical metrics for device development and evaluationTeaching Shared Decision Making to Family Medicine Residents: A Descriptive Study of a Web-Based TutorialAcute exudative tonsillitis in adults: the use of the Centor scoreand some laboratory testsHigh Cytokine Levels in Tonsillitis Secretions Regardless of Presence of Beta-Hemolytic StreptococciHealth Care Competition and Antibiotic Use in TaiwanIdentification and genotypic analysis of Streptococcus pyogenes isolated from pharyngitis and tonsillitis infected children in IBB city in YemenPharyngitisStreptococcus pyogenesKlebsiella pneumoniae pharyngitis mimicking malignancy: a diagnostic dilemmaMolecular and Clinical Diagnosis of Group A Streptococcal Pharyngitis in ChildrenVariability in the Diagnosis and Treatment of Group A Streptococcal Pharyngitis by Primary Care PediatriciansReflexive Culture in Adolescents and Adults With Group A Streptococcal PharyngitisGroup A Streptococcus pharyngitis outbreak among university students in a judo clubEmpirical validation of Polish guidelines for the management of acute streptococcal pharyngitis in childrenMaternal and Fetal Death following Group A Streptococcal Meningitis in Mid-Term PregnancyPRImary care Streptococcal Management (PRISM) study: in vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness studyManagement of acute streptococcal pharyngitis: still the subject of controversyParticipatory Medicine: A Home Score for Streptococcal Pharyngitis Enabled by Real-Time Biosurveillance A Cohort StudyAndrew M. Fine, MD, MPH, Victor Nizet, MD, and Kenneth D. Mandl, MD, MPHWhen Should Patients Seek Care for Sore Throat?Robert M. Centor, MDLemierre's syndrome: the importance of early detectionAcute pharyngitis: low adherence to guidelines highlights need for greater flexibility in managing paediatric casesManagement of Adults with Acute Streptococcal Pharyngitis: Minimal Value for Backup Strep Testing and Overuse of AntibioticsDiagnosis of acute tonsillopharyngitis in primary care: a new approach for low-resource settingsDifferent antibiotic treatments for group A streptococcal pharyngitisA Sustainable Strategy to Prevent Misuse of Antibiotics for Acute Respiratory InfectionsOver prescription of antibiotics for adult pharyngitis is prevalent in developing countries but can be reduced using McIsaac modification of Centor scores: a cross-sectional studyHEENT PitfallsClinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of AmericaIncidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort studyAccuracy and Precision of the Signs and Symptoms of Streptococcal Pharyngitis in Children: A Systematic ReviewOutpatient Antibiotic Prescribing in a Low-Risk Veteran Population with Acute Respiratory SymptomsCochrane Review: Different antibiotic treatments for group A streptococcal pharyngitisAntimicrobial prescribing in the USA for adult acute pharyngitis in relation to treatment guidelinesPredicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor scoreDocumento de consenso sobre el diagnóstico y tratamiento de la faringoamigdalitis agudaImproved Diagnostic Accuracy of Group A Streptococcal Pharyngitis With Use of Real-Time BiosurveillanceAndrew M. Fine, MD, MPH, Victor Nizet, MD, and Kenneth D. Mandl, MD, MPHLemierre's Syndrome Misdiagnosed as Swine FluStreptococcal PharyngitisAnalysis of Different Recommendations From International Guidelines for the Management of Acute Pharyngitis in Adults and ChildrenFusobacterium necrophorum bacteremic tonsillitis: 2 Cases and a review of the literatureSelf-reported familiarity with acute respiratory infection guidelines and antibiotic prescribing in primary careDifferent antibiotic treatments for group A streptococcal pharyngitisInfectious MononucleosisPharyngitis in AdultsUpper Respiratory Tract InfectionsPharyngitisStreptococcus pyogenesExpand the Pharyngitis Paradigm for Adolescents and Young AdultsRobert M. Centor, MDVomiting in the pediatric age groupTécnicas antigénicas rápidas para estreptococo betahemolítico en atención primariaA scoring system for management of acute pharyngo-tonsillitis in adultsMolecular Detection of Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilisAcute respiratory tract infections: When are antibiotics indicated?PharyngitisAntibiotic Prescriptions for Upper Respiratory Tract Infection in JapanAchieving best practice in tonsillitisA Remote Fuzzy Multicriteria Diagnosis of Sore ThroatEconomic Burden of Adult Pharyngitis: The Payer's PerspectivePharyngitisCold Syndrome and Related Diseases - Re-examination of the SyndromeImpact of Guidelines on Antimicrobial Treatment of Respiratory Tract InfectionsAntibiotic Resistance: Modern Principles and Management Strategies to Optimize Outpatient Use of AntibioticsAdverse drug reactions related to amoxicillin alone and in association with clavulanic acid: data from spontaneous reporting in Italy¿Es posible el diagnóstico clínico de la faringoamigdalitis estreptocócica?Group A Beta-Hemolytic Streptococcal Pharyngitis in InmatesPharyngitis and EpiglottitisZakażenia dróg oddechowych. Antybiotykoterapia – tak czy nie? Długo czy krótko?Treating the Immunocompetent Patient Who Presents with an Upper Respiratory Infection: Pharyngitis, Sinusitis, and BronchitisPharyngitis Management: Defining the ControversyOptimal management of adults with pharyngitis – a multi-criteria decision analysisNovel ways of preventing antibiotic-resistant infections: What might the future hold?Evaluation of Culture and Antibiotic Use in Patients With PharyngitisResponse to Differences in Antibiotic PrescribingProtocolo diagn?stico y terap?utico de la faringoamigdalitisCompliance of Resident and Staff Physicians With IDSA Guidelines for the Diagnosis and Treatment of Streptococcal PharyngitisManagement of Acute Pharyngitis in the ER: Not According to HoyleEficácia e segurança de Sultamicilina (Ampicilina/Sulbactam) e Amoxacilina/Clavulanato no tratamento das infecções de via aéreas superiores em adultos: um estudo multicêntrico, aberto e randomizadoHoe wordt klinisch M. Pfeiffer van M. Pfeiffer met een bacteriële superinfect onderscheiden?Efficacy and safety of Sultamicillin (Ampicillin/Sulbactan) and Amoxicillin/Clavulanic Acid in the treatment of upper respiratory tract infections in adults - an open-label, multicentric, randomized trialAcute Infections in Primary Care: Accuracy of Electronic Diagnoses and Electronic Antibiotic PrescribingThe Use of Antibiotics for Viral Upper Respiratory Tract Infections: An Analysis of Nurse Practitioner and Physician Prescribing Practices in Ambulatory Care, 1997-2001Increased Risk of Common Infections in Patients with Type 1 and Type 2 Diabetes MellitusDiagnosis and Treatment of Pharyngitis in ChildrenMacrolides in cystic fibrosisEfectividad de la aplicación de un protocolo clínico para el manejo de la faringitis aguda en adultosAntibiotic prescribing patterns for sore throat infections in a university-based primary care clinicA Pain in the NeckRapid detection and diagnosis of group A streptococcal pharyngitis¿Son los criterios clínicos suficientes para realizar el diagnóstico de faringitis aguda estreptocócica?Systemic antibiotic treatment in upper and lower respiratory tract infections: official French guidelinesAcute PharyngitisRole of the Microbiology Laboratory in Diagnosis and Management of PharyngitisDifferent antibiotic treatments for group A streptococcal pharyngitisDiagnosis and Management of Adults with Pharyngitis: A Cost-Effectiveness AnalysisJoan M. Neuner, MD, MPH, Mary Beth Hamel, MD, MPH, Russell S. Phillips, MD, Kira Bona, BS, and Mark D. Aronson, MDDiagnosing Strep Throat in the Adult Patient: Do Clinical Criteria Really Suffice?Alan L. Bisno, MDEmergence of Macrolide Resistance in Throat Culture Isolates of Group A Streptococci in Ontario, Canada, in 2001Diagnostic rapide de l'angine à streptocoque : quoi de neuf ?Changing Use of Antibiotics in Community-Based Outpatient Practice, 19911999Michael A. Steinman, MD, Ralph Gonzales, MD, MSPH, Jeffrey A. Linder, MD, MPH, and C. Seth Landefeld, MDAntibiothérapie par voie générale en pratique courante : angineNational Guideline Clearinghouse Guideline Synthses and ComparisonsComparison of 5 days of extended-release clarithromycin versus 10 days of penicillin V for the treatment of streptococcal pharyngitis/tonsillitis: results of a multicenter, double-blind, randomized study in adolescent and adult patientsTop Ten Publications of 2001Practice Guidelines for the Diagnosis and Management of Group A Streptococcal PharyngitisDiagnosis of Strep Throat in Adults: Are Clinical Criteria Really Good Enough?Principles of Appropriate Antibiotic Use: Acute PharyngitisGene H. Stollerman, MDAppropriate use of antibiotics for respiratory infections: review of recent statements and position papersAppropriate Use of Antibiotics: PharyngitisAlan L. Bisno, MD and Edward L. Kaplan, MDNicht-streptokokkenbedingte Tonsillopharyngitis bei Kindern: Wirksamkeit eines Extraktes aus Pelargonium sidoides (EPs 7630) im Vergleich zu PlaceboA critical assessment of published guidelines and other decision‐support systems for the antibiotic treatment of community‐acquired respiratory tract infectionsMoving from recommendation to implementation and audit: Part 2. Review of interventions and auditPhysicians' Antibiotic Prescribing Habits for Upper Respiratory Tract Infections in TurkeyLooking Forward at AnnalsHarold Sox, MD, Editor 20 March 2001Volume 134, Issue 6Page: 506-508KeywordsAntibioticsAntigensAntimicrobialsPenicillinPharyngitisPharynxRheumatic feverSpecificityStreptococcusTreatment guidelines ePublished: 20 March 2001 Issue Published: 20 March 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it