Reminder: Appropriate testing for children with Pharyngitis 

Viruses account for 70-80% of pharyngitis in children. It is critical to ensure that patients 2 - 18 years of age diagnosed with pharyngitis and treated with antibiotics receive appropriate testing for streptococcus pharyngitis. To help you test appropriately, we've provided resources on codes and standards below.

 Diagnosis  CDC Principles of Appropriate Testing 
  1. Diagnose as Group A Streptococcal Pharyngitis using a lab test on conjunction with Clinical epidemiological findings
  2. Antibiotics should not be given to a child with Pharyngitis in the absence of diagnosed Group A streptococcal infection 
  3. A penicillin remains the drug of choice for treating Group A Streptococcal Pharyngitis 

Helpful tips

If a patient tests negative for group A strep but insists on an antibiotic:

  • Refer to the illness as a sore throat due to a cold; patients tend to associate the label with a less-frequent need for antibiotics.
  • Write a prescription for symptom relief like over-the-counter medicines.

Educate patients on the difference between bacterial and viral infections (this is a key point in the success of this measure).

Document the performance of a rapid strep test or the parent or caregivers' refusal of testing in medical records.

Discuss with patients ways to treat symptoms:

  • Antibiotic treatment 
  • Get extra rest
  • Drink plenty of fluids
  • Use over-the-counter medications
  • Use a cool-mist vaporizer and nasal spray for congestion
  • Eat ice chips or use throat spray or lozenges for sore throats

Educate patients and their parents or caregivers that they can prevent infection by:

  • Washing hands frequently
  • Keeping an infected person's eating utensils and drinking glasses separate from other family members
  • Thoroughly washing an infected toddler's toys in hot water with disinfectant soap
  • Keeping a child diagnosed with a sore throat out of school or day care until he or she has taken antibiotics for at least 24 hours and until symptoms improve

In accordance to the Advisory Committee on Immunization Practices, administer influenza vaccine annually to all children beginning at age 6 months

For more information, see the MQIC Guidelines for assessing, diagnosing and treating Acute Pharyngitis. 

Additional information can also be found on the American Academy of Pediatrics Website.