| Sumario: | QUESTION: In primary care settings, are antibiotics effective for adults and children with acute sore throats? Data sources: Studies were identified by searching Medline with the terms pharyngitis, sore throat, and tonsillitis; the Cochrane Library; the Cochrane Acute Respiratory Infections Group trials register; and bibliographies of included studies. Inclusion dates of the studies were 1945-99. Study selection: Controlled trials were selected if they compared antibiotics with placebo, if the patients had symptoms of acute sore throat and were in primary care settings, and if outcomes included incidence of acute rheumatic fever within 2 months, acute glomerulonephritis within 1 month, acute otitis media, acute sinusitis, quinsy (peritonsillar abscess), or symptoms of throat soreness, headache, or fever. Data extraction: Data were extracted or sought from the authors of trials on study quality, publication date, patient characteristics, antibiotics including duration, outcomes, symptom resolution, and adverse effects. Main results: 22 studies (10 484 cases of sore throat) met the inclusion criteria. Most were done in the 1950s although 4 were recently published (1996-99). Analyses of all antibiotics together and only trials of penicillin showed reductions in the incidence of acute rheumatic fever; antibiotics also showed modest reductions in the incidence of acute otitis media, quinsy, and symptoms of fever, throat soreness, and headache at day 3 (table). Antibiotics did not prevent acute glomerulonephritis within 2 months or sinusitis within 14 days. Subgroup analyses showed that these results were not changed when blinding, use of antipyretics, confirmed streptococcus infections, or age of the patients were analysed. Data were insufficient to report on adverse effects. Conclusion: In patients with acute sore throat, antibiotics provide modest benefit for reducing symptoms of throat soreness, fever, and headache at day 3 and the incidence of rheumatic fever, otitis media, and quinsy. [Original article accession number: 2000029475 (research, systematic review, tables/charts)]
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