Howe, Robert William (1996) A study of sore throats in general practice. University of Southampton, Doctoral Thesis.
Abstract
This work examines a common illness in general medical practice, that of a patient presenting with a sore throat, and examines critically the medical and social issues which determine the way in which the presenting symptom is managed and treated medically by general practitioners.
The use of antibiotics is discussed, and the merit of antibiotic treatment to shorten the duration and severity of the symptoms experienced by patients is brought into question.
A clinical trial is described, for which specific outcome measures were developed, to try to answer the question if antibiotic treatment is of symptomatic benefit to patients with a sore throat who present to their general practitioner and who are selected for antibiotic treatment.
The clinical trial demonstrated that penicillin treatment did not improve symptom resolution in the study population. The trial demonstrated an improvement in symptom resolution with cefixime treatment.
The observed improvement in symptom resolution occurred in patients irrespective of the isolation of group A beta-haemolytic streptococcus (GABHS) from the throat with a throat swab. It is suggested that the benefit in symptom resolution derived from cefixime is not related to the antibiotic effect of cefixime on GABHS.
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