Sore throat is a very common symptom, but treatment recommendations remain controversial.
Many official recommendations are influenced by the danger of rheumatic fever, a condition that has undergone a dramatic change in epidemiology over the past few decades. Two reviews by Canadian physicians conclude that current recommendations are not likely to prevent rheumatic fever and may lead to overuse of antibiotics. Only one of several proposed clinical scoring systems has been validated in practice to aid in the selection of appropriate management for sore throat. When no community epidemic has been identified, patients with a score of zero have a chance of streptococcal infection that is less than 3 percent. This chance rises to 41 to 61 percent for those scoring 4.