New guidelines by the Infectious Diseases Society of America said 15 million people in the United States see the doctor each year complaining of sore throat, but fewer than one-third have strep throat, yet up to 70 percent receive antibiotics, which are ineffective against viruses.
The newly revised guidelines, published in the journal Clinical Infectious Diseases, for Group A streptococcal pharyngitis -- strep throat -- also advise that when a strep infection is confirmed by testing, it should be treated with penicillin or amoxicillin, if the patient does not have an allergy, and not azithromycin or a cephalosporin.
Further, the guidelines recommend children who suffer from recurrent strep throat should not have their tonsils surgically removed solely to reduce the frequency of infection.
The guidelines noted children and adults do not need to be tested for strep throat if they have a cough, runny nose, hoarseness and mouth sores, which are strong signs of a viral throat infection.
A sore throat is more likely caused by strep if the pain comes on suddenly, swallowing hurts and the sufferer has a fever without the above listed features, but this should be confirmed via a rapid antigen detection test before antibiotics are prescribed, the guidelines advised.
"The guidelines promote accurate diagnosis and treatment, particularly in avoiding the inappropriate use of antibiotics, which contributes to drug-resistant bacteria," lead author Dr. Stanford T. Shulman, chief of the division of infectious diseases at Ann & Robert H. Lurie Children's Hospital of Chicago, said in a statement.