Template
Pharyngitis
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Diagnosis qualifierChoose anyFirst line
FindingsChoose any
Result and planChoose one
AntibioticChoose one
Recurrence and referralChoose any
Additional counselingChoose any
Follow-upChoose one
Supportive careChoose anyParagraph
Counseling
Return precautions given including trouble swallowing or breathing, drooling, neck swelling or stiffness, not drinking well, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
What the sources cover
- Positive rapid strep: treat
- Positive strep PCR/NAAT: treat
- Positive throat culture (after negative rapid): treat
- Negative rapid: backup culture or PCR, antibiotics on hold
- Negative PCR/NAAT: no antibiotics (no confirmation needed)
- Negative rapid and negative culture: no antibiotics
- Viral features (rhinorrhea, cough, hoarseness, oral ulcers): no testing or treatment
- IM penicillin G benzathine
- Amoxicillin first line
- Penicillin V
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- Cephalexin (Keflex), cefadroxil for nonanaphylactic allergy
- Clindamycin for anaphylactic allergy
- Azithromycin, clarithromycin (macrolides) for allergy
- Reason: nonanaphylactic penicillin allergy
- Reason: anaphylactic penicillin allergy
- Reason: recurrence shortly after a full oral course
- Take the full course even when better (ARF prevention)
- Analgesic/antipyretic for symptoms
- Return to school when well and ≥ 12 h after starting antibiotics
- Scarlet fever (same management)
- Symptomatic household contacts tested; asymptomatic contacts not
- Frequent positive tests: likely carrier with viral illnesses
- Suppurative complications (peritonsillar/retropharyngeal abscess)
- Follow-up: not improving in 2–3 days
- Follow-up: culture result by phone
Used to decide, kept out of the note
- Under 3 years: testing generally not recommended (consider with infected sibling)
- No tetracyclines, TMP-SMX, fluoroquinolones
- Avoid aspirin in children
- No corticosteroids
- No routine test of cure
- Tonsillectomy not solely to reduce GAS frequency
Return precautions in the template
trouble swallowing or breathingdroolingneck swelling or stiffnessnot drinking well