Sore throat is one of the most common presenting complaints in outpatient medicine, so urgent care clinicians must be experts in evaluating and treating patients with pharyngitis. The differential diagnosis for pharyngitis is broad and includes a few serious disease processes that must be quickly ruled out. This issue reviews international guidelines for pharyngitis and discusses controversies and recent advances in diagnostic and treatment strategies, specifically for management of suspected bacterial and viral etiologies.
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Following are the most informative references cited in this paper, as determined by the authors.
2. Chow AW, Doron S. Evaluation of acute pharyngitis in adults. 2020. Updated August 24, 2022. Accessed September 10, 2022. (Review)
8. * Spinks A, Glasziou PP, Del Mar CB. Antibiotics for treatment of sore throat in children and adults. Cochrane Database Syst Rev. 2021;12(12):CD000023. (Systematic review; 15,337 patients) DOI: 10.1002/14651858.CD000023.pub5
11. * Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):1279-1282. (Guideline) DOI: 10.1093/cid/cis847
12. * ESCMID Sore Throat Guideline Group, Pelucchi C, Grigoryan L, et al. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012;18 Suppl 1:1-28. (Guideline) DOI: 10.1111/j.1469-0691.2012.03766.x
41. * Centor RM, Witherspoon JM, Dalton HP, et al. The diagnosis of strep throat in adults in the emergency room. Med Decis Making. 1981;1(3):239-246. (Prospective study; 286 patients) DOI: 10.1177/0272989X8100100304
48. * Snow V, Mottur-Pilson C, Cooper RJ, et al. Principles of appropriate antibiotic use for acute pharyngitis in adults. Ann Intern Med. 2001;134(6):506-508. (Guideline) DOI: 10.7326/0003-4819-134-6-200103200-00018
55. * Cooper RJ, Hoffman JR, Bartlett JG, et al. Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann Intern Med. 2001;134(6):509-517. (Guideline) DOI: 10.7326/0003-4819-134-6-200103200-00019
107. American Medical Association. CPT® evaluation and management (E/M) office or other outpatient (99202-99215) and prolonged services (99354, 99355, 99356, 99417) code and guideline changes. 2021. Accessed September 10, 2022. (Summary of coding guidelines)
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Keywords: sore throat, pharyngitis, strep throat, streptococcal pharyngitis, group A beta-hemolytic Streptococcus, GABHS, GAS, Fusobacterium, mononucleosis, gonococcal pharyngitis, syphilitic pharyngitis, F necrophorum, NAAT, RADT, throat culture, Epstein-Barr virus, scarlet fever, acute rheumatic fever, antibiotics, Centor score, nucleic acid amplification testing, Lemierre syndrome, peritonsillar abscess, Ludwig angina, corticosteroids, tonsillectomy
Keith Pochick, MD, FACEP
Attending Physician, Urgent Care
James B. Short, Jr., MD, FAAFP, BCUCM
Linda Aanonsen, PA-C
Brad Laymon, PA-C, CPC, CEMC
October 1, 2022
October 1, 2025   CME Information
4 AMA PRA Category 1 Credits™. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits
Price: $59
+4 Credits!
Keith Pochick, MD, FACEP
Attending Physician, Urgent Care
James B. Short, Jr., MD, FAAFP, BCUCM
Linda Aanonsen, PA-C
Brad Laymon, PA-C, CPC, CEMC
October 1, 2022
October 1, 2025
4 AMA PRA Category 1 Credits™. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits
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