Comparative costs of diagnosis and treatment in acute pharyngitis

Throat cultures from 86 consecutive patients with a clinical diagnosis of pharyngitis yielded 23 (27%) that were positive for beta-hemolytic streptococci. The cost of using oral antibiotics and of obtaining and processing throat cultures was determined. Using these data the following two theoretic strategies were cost accounted: Strategy A: Empiric Treatment. Obtain no cultures but treat all patients with oral antibiotics for ten days. Total cost = the cost of antibiotics for 86 patients. Strategy B? Selective Treatment. Obtain throat cultures on all patients. Treat patients have cultures positive for beta-hemolytic streptococci with a ten-day course of oral antibiotics. Costs were similar for the two strategies. Culture costs are itemized, and methods for cost reduction are suggested. This study presents economic justification for selective treatment as the appropriate approach in the majority of cases of acute pharyngitis of undetermined cause.