Abstract：
There is a very large body of publications discussing the management of patients with an acute sore throat. Advocates for a restrictive antibiotic policy and advocates for a more liberal use of antibiotics emphasise different and valid arguments and to date have not been able to unite in a consensus. Contradicting guidelines based on the same body of knowledge is not logical, may cause confusion and cause unwanted variation in clinical management.
In multiple video meetings and email correspondence from March to November 2022 and finally in a workshop at the annual meeting for the North American Primary Care Group in November 2022, experts from different countries representing different traditions agreed on how the current evidence should be interpreted.
This critical analysis identifies that the problem can be resolved by introducing a new triage scheme considering both the acute risk for suppurative complications and sepsis as well as the long-term risk of developing rheumatic fever.
The new triage scheme may solve the long-standing problem of advocating for a restrictive use of antibiotics while also satisfying concerns that critically ill patients might be missed with severe consequences. We acknowledge that the perspective of this problem is vastly different between high- and low-income countries. Furthermore, we discuss the new trend which allows nurses and pharmacists to independently manage these patients and the increased need for safety netting required for such management.
In multiple video meetings and email correspondence from March to November 2022 and finally in a workshop at the annual meeting for the North American Primary Care Group in November 2022, experts from different countries representing different traditions agreed on how the current evidence should be interpreted.
This critical analysis identifies that the problem can be resolved by introducing a new triage scheme considering both the acute risk for suppurative complications and sepsis as well as the long-term risk of developing rheumatic fever.
The new triage scheme may solve the long-standing problem of advocating for a restrictive use of antibiotics while also satisfying concerns that critically ill patients might be missed with severe consequences. We acknowledge that the perspective of this problem is vastly different between high- and low-income countries. Furthermore, we discuss the new trend which allows nurses and pharmacists to independently manage these patients and the increased need for safety netting required for such management.
摘要：
■有大量的出版物讨论急性咽喉痛患者的治疗。限制性抗生素政策的倡导者和更自由使用抗生素的倡导者强调不同和有效的论点，迄今为止尚未达成共识。基于相同知识体系的相互矛盾的指导方针是不符合逻辑的，可能会导致混乱，并在临床管理中造成不必要的变化。
在2022年3月至11月的多次视频会议和电子邮件通信中，以及最后在2022年11月的北美初级保健小组年会上的研讨会上，来自代表不同传统的不同国家的专家就如何解释当前证据达成了一致。
■这项关键分析确定，通过引入新的分诊方案可以解决该问题，同时考虑化脓性并发症和败血症的急性风险以及发展为风湿热的长期风险。
新的分诊方案可能会解决长期以来提倡限制使用抗生素的问题，同时也会解决危重病人可能因严重后果而错过的担忧。我们承认，高收入国家和低收入国家对这一问题的看法大不相同。此外，我们讨论了允许护士和药剂师独立管理这些患者的新趋势，以及这种管理对安全网的需求增加。
在2022年3月至11月的多次视频会议和电子邮件通信中，以及最后在2022年11月的北美初级保健小组年会上的研讨会上，来自代表不同传统的不同国家的专家就如何解释当前证据达成了一致。
■这项关键分析确定，通过引入新的分诊方案可以解决该问题，同时考虑化脓性并发症和败血症的急性风险以及发展为风湿热的长期风险。
新的分诊方案可能会解决长期以来提倡限制使用抗生素的问题，同时也会解决危重病人可能因严重后果而错过的担忧。我们承认，高收入国家和低收入国家对这一问题的看法大不相同。此外，我们讨论了允许护士和药剂师独立管理这些患者的新趋势，以及这种管理对安全网的需求增加。
