Table 2.
Comparison of the Recommendations in Acute Sore Throat Guidelines
| European Guidelines | North American Guidelines | |||||||||
| Diagnosis and Treatment | Belgium44 BE01 | The Netherlands45 NL02 | France46 FR03 | Finland47 FI04 | England48 E05 | Scotland49 SC06 | Canada50 CA07 | ICSI51 US08 | IDSA52 US09 | Position Paper (ACP)53 US10 |
| Diagnosis | ||||||||||
| History | + | + | + | + | + | + | + | + | + | + |
| Clinical examination | + | + | + | + | + | + | + | + | + | + |
| Centor criteria | − | − | − | − | − | − | + | + | + | + |
| GABHS (rapid antigen or strep) test | − | − | + | + | − | − | − | + | + | + |
| Culture | − | − | − | + | − | − | + | +* | +* | − |
| Treatment | ||||||||||
| Prescribe antibiotics | ||||||||||
| High-risk and very ill patients | + | + | + | − | + | + | + | + | + | + |
| Centor criteria | − | − | − | − | − | − | − | − | − | + |
| GABHS test result positive | − | − | + | + | − | − | − | + | + | + |
| GABHS test result negative; culture positive | − | − | + | + | − | − | − | + | + | − |
| Culture positive | − | − | − | + | − | − | + | + | + | − |
| Reason for antibiotics | ||||||||||
| Shorten clinical evolution | + | + | + | + | − | − | + | + | + | + |
| Prevent ARF | − | − | + | + | − | − | + | + | + | + |
| Prevent GNF | − | − | − | − | − | − | − | − | − | − |
| Prevent local complications | − | − | − | − | − | − | + | − | + | + |
| Limit spread of GABHS | − | + | + | + | + | + | + | + | + | + |
| Small-spectrum penicillin | + | + | + | + | + | + | + | + | + | + |
ACP = American College of Physicians; ARF = acute rheumatic fever; GABHS = group A β-hemolytic streptococci; GNF = glomerulonephritis; ICSI = Institute for Clinical Systems Improvement; ISDA = Infectious Disease Society of America.
* If a rapid antigen (strep) test is not available.