Resolving the sore throat dilemma.

Many physicians ignore the traditional dictum that throat culture is the only tool of value in assessing sore throat. A review of the literature supports this skepticism. Evidence indicates that clinical assessment has been underestimated and the significance of positive culture exaggerated.An approach to managing pharyngitis utilizing the combined strengths of throat culture and clinical assessment is proposed. This approach avoids needless cultures, minimizes unnecessary antibiotic use, achieves prompt clinical improvement in patients whose symptoms are most severe and reduces the risk of long term morbidity from rheumatic heart disease to negligible levels.