Streptococal throat infections in family practice

Beta hemolytic streptococcal throat infections occur often enough and cause sufficient morbidity that careful diagnosis and appropriate treatment are matters of concern to the family physician and others involved in primary patient care. Throat cultures aid the precision of diagnosis; a simple, inexpensive, and accurate method of performing cultures in the office is described. The risk of rheumatic fever secondary to untreated streptococcal infections appears to be less than it once was, and further work defining this risk in various population groups is needed. Penicillin remains the drug of choice for treatment, with blood levels maintained for at least ten days either by oral administration or by a single intramuscular dose of benzathine penicillin G. The results of a recent survey of US family practice programs and an equivalent number of practicing family physicians show that most physicians use a selective approach to diagnosis and treatment of throat infections based on symptoms, signs, and age of the patient.