Sore throat presentation and management in general practice

Abstract

Aims: To compare the characteristics of sore throat patients with their having normal throat, to measure the incidence of beta-haemolytic streptococcal growth in both groups, and to determine the clinical outcomes of treating sore throat patients without the aid of a throat swab.

Method: Patients were from a suburban general practice. A three phased prospective study of consecutive patients with sore throats as their primary complaint, or with normal throats.

Results: Patients presented with a sore throat at a rate of 45 per 1000 consultations and those with normal throats presented at a rate of 379 per 1000 consultations. 43% of normal throat patients were male compared to 34% with sore throat (chi 2 = 4.62, p < 0.02). The incidence of beta-haemolytic streptococcal growth in sore throat patients was 123 per 1000 consultations per year. 23% of people 14 years and younger had a positive growth compared to 9% of people over 14 years of age. (chi 2 = 5.04, df = 1, p < 0.05). The sore throat presentation peaked over the late autumn to early winter months (June-July) but the beta-haemolytic streptococcal infection rate remained low throughout the year. A history of pain for less than three days and fever, and on examination large neck glands and pus on the tonsils were all positive clinical features for beta-haemolytic streptococcal infection. However use of clinical criteria alone meant 73% of patients with no beta-haemolytic streptococcal infection were falsely treated.

Conclusion: Research is needed to develop guidelines for the management of sore throats in general practice.