Hedges J R, Lowe R A
Am J Emerg Med. 1986 Mar;4(2):107-15. doi: 10.1016/0735-6757(86)90153-1.
Potential streptococcal pharyngitis represents a common presenting complaint of patients in emergency departments. Studies have shown that therapy within the first 48 hours of presentation hastens the resolution of the infection. A prior analysis of the cost of treatment for potential streptococcal pharyngitis in an outpatient practice suggested that when the likelihood of a positive throat culture is high, therapy is more cost effective without a throat culture. The current analysis evaluates the effects of emergency department charges, incomplete follow-up, and several common screening tests (Gram stain, clinical scoring) upon the cost of treatment and the risk for rheumatic fever. The results of the current analysis support the use of common screening tests to permit immediate oral or parenteral penicillin treatment of selected patients without a throat culture and the use of a throat culture to detect false-negative screen results.
潜在的链球菌性咽炎是急诊科患者常见的就诊主诉。研究表明，在就诊后的48小时内进行治疗可加速感染的消退。先前对门诊治疗潜在链球菌性咽炎的成本分析表明，当咽拭子培养阳性的可能性很高时，不进行咽拭子培养而进行治疗更具成本效益。当前的分析评估了急诊科收费、随访不完整以及几种常见筛查试验（革兰氏染色、临床评分）对治疗成本和风湿热风险的影响。当前分析的结果支持使用常见筛查试验，以便在不进行咽拭子培养的情况下对选定患者立即进行口服或胃肠外青霉素治疗，并使用咽拭子培养来检测筛查结果的假阴性。
