TABLE 3

Physicians' Approach to a Child or Adolescent With Classic Clinical and Epidemiologic Findings Consistent With Acute GAS Pharyngitis (First Clinical Scenario) and With Viral Pharyngitis (Second Clinical Scenario)

Management ApproachAppropriate Management?Total No. (%) of RespondentsaNo. (%) of PediatriciansbNo. (%) of Family Physicianscχ2Pd
First clinical scenario
    RADT; start Abxs if RADT (+); if RADT (−), obtain CX and start Abxs but stop if CX (−)Yes279 (30)125 (30)154 (30).94
    RADT; start Abxs if RADT (+); if RADT (−), obtain CX and start Abxs only if CX (+)Yes270 (29)190 (46)80 (16)<.01
    CX; start Abxs, but stop if CX (−)Yes66 (7)26 (6)40 (8).38
    CX; start Abxs only if CX (+)Yes13 (1)10 (2)3 (1).02
    RADT; start Abxs only if RADT (+)No84 (9)35 (8)49 (10).57
    No tests, start Abxs based on clinical criteriaNo144 (16)13 (3)131 (25)<.01
    RADT and/or CX; start and continue Abxs regardless of resultsNo72 (8)15 (4)57 (11)<.01
    No tests, no AbxsNo000
Second clinical scenario
    No tests, no AbxsYese174 (19)80 (19)94 (18).70
    RADT; start Abxs if RADT (+); if RADT (−), obtain CX and start Abxs only if CX (+)No326 (35)197 (47)129 (25)<.01
    RADT; start Abxs only if RADT (+)No299 (32)97 (23)202 (39)<.01
    CX; start Abxs only if CX (+)No78 (8)27 (6)51 (10).06
    RADT; start Abxs if RADT (+); if RADT (−), obtain CX and start Abxs but stop if CX (−)No23 (2)9 (2)14 (3).59
    CX; start Abxs, but stop if CX (−)No11 (1)2 (<1)9 (2).08
    No tests, start Abxs based on clinical criteriaNo19 (2)5 (1)14 (3).10
    RADT and/or CX; start and continue Abxs regardless of resultsNo4 (<1)04 (1).13f
  • Abxs indicates antibiotics; CX, culture.

  • a Note that there were missing responses, because not all 948 respondents chose to respond to the scenario. n = 928 in the first and 934 in the second clinical scenario.

  • b n = 414 in the first and 417 in the second clinical scenario.

  • c n = 514 in the first and 517 in the second clinical scenario.

  • d Comparing pediatricians and family physicians.

  • e Guidelines recommend no testing when clinical and epidemiological findings are consistent with viral pharyngitis.

  • f Calculated by using 2-sided Fisher's exact test.