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Differences among international pharyngitis guidelines : not just academic

Jan Matthys (UGent) , Marc De Meyere (UGent) , Marie van Driel (UGent) and An De Sutter (UGent)
(2007) ANNALS OF FAMILY MEDICINE. 5(5). p.436-443
Author
Organization
Abstract
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.
Keywords
practice guideline [publication type], acute sore throat, pharyngitis, primary health care, family practice, evidence-based medicine, CLINICAL-PRACTICE GUIDELINES, ACUTE RHEUMATIC-FEVER, STREPTOCOCCAL PHARYNGITIS, GENERAL POPULATION, PRIMARY-CARE, SORE THROAT, SYSTEMATIC REVIEWS, ATTACK RATE, GLOMERULONEPHRITIS, ANTIBIOTICS

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Citation

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MLA
Matthys, Jan, et al. “Differences among International Pharyngitis Guidelines : Not Just Academic.” ANNALS OF FAMILY MEDICINE, vol. 5, no. 5, 2007, pp. 436–43, doi:10.1370/afm.741.
APA
Matthys, J., De Meyere, M., van Driel, M., & De Sutter, A. (2007). Differences among international pharyngitis guidelines : not just academic. ANNALS OF FAMILY MEDICINE, 5(5), 436–443. https://doi.org/10.1370/afm.741
Chicago author-date
Matthys, Jan, Marc De Meyere, Marie van Driel, and An De Sutter. 2007. “Differences among International Pharyngitis Guidelines : Not Just Academic.” ANNALS OF FAMILY MEDICINE 5 (5): 436–43. https://doi.org/10.1370/afm.741.
Chicago author-date (all authors)
Matthys, Jan, Marc De Meyere, Marie van Driel, and An De Sutter. 2007. “Differences among International Pharyngitis Guidelines : Not Just Academic.” ANNALS OF FAMILY MEDICINE 5 (5): 436–443. doi:10.1370/afm.741.
Vancouver
1.
Matthys J, De Meyere M, van Driel M, De Sutter A. Differences among international pharyngitis guidelines : not just academic. ANNALS OF FAMILY MEDICINE. 2007;5(5):436–43.
IEEE
[1]
J. Matthys, M. De Meyere, M. van Driel, and A. De Sutter, “Differences among international pharyngitis guidelines : not just academic,” ANNALS OF FAMILY MEDICINE, vol. 5, no. 5, pp. 436–443, 2007.
@article{383098,
  abstract     = {{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.}},
  author       = {{Matthys, Jan and De Meyere, Marc and van Driel, Marie and De Sutter, An}},
  issn         = {{1544-1709}},
  journal      = {{ANNALS OF FAMILY MEDICINE}},
  keywords     = {{practice guideline [publication type],acute sore throat,pharyngitis,primary health care,family practice,evidence-based medicine,CLINICAL-PRACTICE GUIDELINES,ACUTE RHEUMATIC-FEVER,STREPTOCOCCAL PHARYNGITIS,GENERAL POPULATION,PRIMARY-CARE,SORE THROAT,SYSTEMATIC REVIEWS,ATTACK RATE,GLOMERULONEPHRITIS,ANTIBIOTICS}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{436--443}},
  title        = {{Differences among international pharyngitis guidelines : not just academic}},
  url          = {{http://dx.doi.org/10.1370/afm.741}},
  volume       = {{5}},
  year         = {{2007}},
}

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