Objective
To assess the justification for the use of antibiotics in the management of sore throat in general practice.
Data sources
The literature from 1945 to 1990 was systematically screened to identify studies that addressed the question whether antibiotics reduce non‐suppurative and suppurative complications and symptoms of sore throat. The key‐words, “pharyngitis” and “tonsillitis” were used to identify trials of antibiotics for the treatment of sore throat.
Study selection
Studies were included in comparison tables if they involved the trial of one or more antibiotics against a control and there was an outcome in terms of reduction in the incidence of acute rheumatic fever, acute glomerulonephritis, acute otitis media, acute sinusitis, quinsy or any symptoms related to the acute illness.
Results
The published literature suggests that antibiotic treatment protects patients with sore throat against acute rheumatic fever and some suppurative complications, but not against acute glomerulonephritis. It does not reduce the symptoms.
Conclusions
In Australia, with the exception of socioeconomically deprived Aboriginal communities, the incidence of acute rheumatic fever is probably not high enough to justify the use of antibiotics for sore throat. Protection against suppurative infection seems to be slight and it is difficult to establish the benefit of antibiotic treatment for reducing the symptoms of sore throat. Until more benefits for antibiotic management of sore throat can be demonstrated, it is recommended that infrequent use be adopted.
There is conflicting evidence regarding the efficacy of prolotherapy injections in reducing pain and disability in patients with chronic low back pain. Conclusions are confounded by clinical heterogeneity among studies and by the presence of co-interventions. There was no evidence that prolotherapy injections alone were more effective than control injections alone. However, in the presence of co-interventions, prolotherapy injections were more effective than control injections, more so when both injections and co-interventions were controlled concurrently.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.