Reported management of patients with sore throat in Australian general practice

Sore throat is one of the commonest presenting symptoms in general practice in Australia, and results in the prescription of an antibiotic in 50-90% of cases, despite the finding of bacterial throat infection in around 30% of cases or fewer.

This study set out to examine whether inaccurate knowledge about the pathophysiological features and management of sore throat helps to explain the high level of inappropriate antibiotic prescribing for sore throat by general practitioners.

A questionnaire with four case vignettes of sore throat presentations was sent to 400 randomly selected general practitioners, practising in Victoria, Australia. Of 367 eligible respondents, 284 responded (77%).

Of the respondents 97% reported that they would prescribe an antibiotic for the case of tonsillitis, 70% for the case of possible glandular fever, 29% for the child with probable viral sore throat and 9% for the adult with probable viral infection. There were no differences in prescribing rates between general practitioners of different sex, practice location, practice type or qualification. Overall, 25% of the antibiotics which formed the respondents' first choice were inappropriate broad-spectrum antibiotics.

General practitioners are generally accurate in their assessment of the features of sore throats, but less accurate in their knowledge of appropriate antibiotics.