This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Bacterial Infections  • Otolaryngology/ Head & Neck Surgery  • Otolaryngology/ Head & Neck Surgery, Other  • Diagnosis  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Gonzales and colleagues argue that they have already provided an explicit rationale for the treatment recommendations they describe. However, they and others have recommended that prospective studies should be conducted to compare the strategies outlined in their principles for the diagnosis of suspected GAS pharyngitis.^1-2 Indeed, our study does provide prospectively collected empirical data to test several possible strategies to diagnose GAS pharyngitis.

There is controversy about the implications of widespread implementation of the ACP-ASIM/AAFP/CDC principles for management of suspected GAS pharyngitis in adults.¹ One major concern is about the assertion that clinical features alone are sufficient to accurately diagnose clinically important cases of GAS pharyngitis and that microbiological tests are never needed.^2-3

We found that relying on 3 or 4 of the clinical features in the Centor score (ie, fever, absence of cough, tender enlarged cervical lymph nodes, and tonsillar swelling or exudates) without testing is . . . [Full Text of this Article]

James D. Kellner, MD, MSc
Department of Pediatrics
Alberta Children's Hospital
University of Calgary

Warren J. McIsaac, MD, Msc
wmcisaac@mtsinai.on.ca
Department of Family and Community Medicine

Donald E. Low, MD
Department of Microbiology
Mt Sinai Hospital
Department of Laboratory Medicine and Pathobiology
University of Toronto
Toronto, Ontario

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Strategies to Diagnose and Treat Group A Streptococcal Pharyngitis
Ralph Gonzales, Richelle J. Cooper, and Jerome R. Hoffman
JAMA. 2004;292(2):167.
EXTRACT | FULL TEXT  

Empirical Validation of Guidelines for the Management of Pharyngitis in Children and Adults
Warren J. McIsaac, James D. Kellner, Peggy Aufricht, Anita Vanjaka, and Donald E. Low
JAMA. 2004;291(13):1587-1595.
ABSTRACT | FULL TEXT