PT  - JOURNAL ARTICLE
AU  - Jan Matthys
AU  - Marc De Meyere
AU  - Mieke L. van Driel
AU  - An De Sutter
TI  - Differences Among International Pharyngitis Guidelines: Not Just Academic
AID  - 10.1370/afm.741
DP  - 2007 Sep 01
TA  - The Annals of Family Medicine
PG  - 436--443
VI  - 5
IP  - 5
4099  - http://www.annfammed.org/content/5/5/436.short
4100  - http://www.annfammed.org/content/5/5/436.full
SO  - Ann Fam Med2007 Sep 01; 5
AB  - PURPOSE Many countries have national guidelines for the treatment of pharyngitis. We wanted to compare the recommendations and the reported evidence in national guidelines for the management of acute sore throat in adults. METHODS Guidelines were retrieved via MEDLINE and EMBASE and through a Web-based search for guideline development organizations. The content of the recommendations and the underlying evidence were analyzed with qualitative and bibliometric methods. RESULTS We included 4 North American and 6 European guidelines. Recommendations differ with regard to the use of a rapid antigen test and throat culture and with the indication for antibiotics. The North American, French, and Finnish guidelines consider diagnosis of group A streptococcus essential, and prevention of acute rheumatic fever remains an important reason to prescribe antibiotics. In 4 of the 6 European guidelines, acute sore throat is considered a self-limiting disease and antibiotics are not recommended. The evidence used to underpin these guidelines was different in North America and Europe. North American guidelines cited more North American references than did European guidelines (87.2% vs 48.0%; ods ratio, 4.6–11.9; P<.001). CONCLUSION Although the evidence for the management of acute sore throat is easily available, national guidelines are different with regard to the choice of evidence and the interpretation for clinical practice. Also a transparent and standardized guideline development method is lacking. These findings are important in the context of appropriate antibiotic use, the problem of growing antimicrobial resistance, and costs for the community.