Pichichero M E
University of Rochester School of Medicine and Dentistry, New York.
Am Fam Physician. 1992 Jan;45(1):199-205.
A throat culture is necessary for accurate diagnosis of group A beta-hemolytic streptococcal tonsillopharyngitis. The use of penicillin therapy in every patient with sore throat results in overtreatment of 85 percent of children and 95 percent of adults presenting to family physicians with the complaint of sore throat. Indiscriminate use of penicillin also increases the risk of drug side effects and subjects some patients to unnecessary alterations of microbial ecology. The signs and symptoms of group A beta-hemolytic streptococcal tonsillopharyngitis are nonspecific, and reliable clinical diagnosis is difficult. Throat culture is cost-effective and, if properly obtained and processed, more than 95 percent accurate. Antigen detection tests (rapid strep tests) are a viable laboratory alternative to throat cultures if these tests are properly performed and if negative test results are confirmed with traditional throat culture.
进行咽拭子培养对于准确诊断 A 组β溶血性链球菌性扁桃体咽炎是必要的。对每一位咽痛患者都使用青霉素治疗，会导致 85%的儿童患者和 95%因咽痛前来家庭医生处就诊的成人患者接受过度治疗。滥用青霉素还会增加药物副作用的风险，并使一些患者的微生物生态发生不必要的改变。A 组β溶血性链球菌性扁桃体咽炎的体征和症状不具有特异性，可靠的临床诊断很困难。咽拭子培养具有成本效益，如果采集和处理得当，准确率超过 95%。如果抗原检测试验（快速链球菌试验）操作得当且阴性检测结果用传统咽拭子培养进行确认，那么这些试验是咽拭子培养可行的实验室替代方法。
