The Article in Brief

Differences Among International Pharyngitis Guidelines: Not Just Academic.

Jan Matthys, MD , and colleagues

Background This study compares recommendations and reported evidence in guidelines for managing sore throat in adults. Four North American and 6 European guidelines were included in the study.

What This Study Found The recommendations differ from one another in terms of testing for and treating sore throat. In France, North America, or Finland, a diagnostic test will be performed and the treatment depends on its result. In England, Scotland, Belgium, or the Netherlands, doctors will not use a test, and the decision to prescribe penicillin depends mainly on the severity of the patient’s illness. The evidence used to support these guidelines is different in North America and Europe. North American guidelines cite more North American references than do European guidelines.

Implications

• Differences among guidelines have important consequences for medical practice. A patient seeing a family physician for acute sore throat will be managed differently according to country.
• Both approaches to diagnosing and treating sore throat found in this study are based on scientific evidence. The differences seem to be related to selection and/or interpretation of information.
• The authors suggest that introducing a method for developing guidelines in Europe and North American may lead to more uniformity in diagnosing and managing sore throat.