Throat infections and use of streptococcal antigen test and antibiotic treatment in general practice; a web-based survey

OBJECTIVE: The aim of this study was to investigate the use of streptococcal antigen tests and antibiotic prescription in general practice in Norway in relation to the national guidelines for sore throat. DESIGN: This study was based on a web-based survey. SETTING: Norwegian general practice. SUBJECTS: 4700 members of the Norwegian College of General Practice received the survey by E-mail. MAIN OUTCOME MEASURES: General practitioner (GP) adherence to national guidelines. RESULTS: In total, 807 GPs responded and were included in the study. According to the guidelines, 20% and 30% of the GPs would perform unnecessary streptococcal antigen testing when presented with mild and severe infections respectively, while 52% would not perform the test at moderate infection. Phenoxymethylpenicillin was recommended by 95% of the GPs. CONCLUSION: In this survey of self-selected GPs, we identified some non-adherence to National guidelines for streptococcal antigen testing and antibiotic prescribing. However, when antibiotic treatment was offered, the correct antibiotics were prescribed. KEY POINTS: Norwegian guidelines for diagnosis and treatment of throat infections include the use of Centor criteria as a clinical tool to limit the unnecessary use of antibiotics. In this web-based survey, we investigated the use of streptococcal antigen tests and antibiotic prescription in general practice in relation to the national guidelines. •Streptococcal antigen tests were not always performed according to Norwegian guidelines, causing inappropriate antibiotic prescribing. •National guidelines were followed in the choice of antibiotics for sore throat.