Patients' willingness to take risks in the management of pharyngitis

Choosing a management plan for pharyngitis involves considering the risks and benefits of alternatives. Using a sick-day equivalent scale, this study examined patients' willingness to be ill with pharyngitis compared with their willingness to risk two outcomes: a penicillin reaction and rheumatic fever. On average, patients preferred 1.5 to 2.5 days of illness with pharyngitis over risking a 5-percent chance of developing a mild penicillin reaction. Willingness to risk the outcomes decreased with increasing probabilities of their occurrence. Subjects were more willing to risk a penicillin reaction than rheumatic fever. Healthy subjects receiving sick pay were more willing to risk varying probabilities of a mild penicillin reaction than subjects not receiving sick pay. Patients ill with pharyngitis, however, were not more willing to take similar risks if they received sick pay. Illness may, therefore, modify some aspects of risk-taking behavior. It is reasonable to conclude that some patients with pharyngitis would prefer early antibiotic treatment for the chance of earlier recovery over waiting for throat culture results despite the risk of a penicillin reaction.