ArticleBMJ (Clinical research ed.)2013
Predictors of suppurative complications for acute sore throat in primary care: prospective clinical cohort study.
Article in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 5 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Efficacy and safety of 24 antibiotics for group A streptococcal pharyngitis: a network meta-analysis of 64 randomized controlled trials.Frontiers in public health · 2026Pooled it
- Predictors of rheumatic fever in sore throat patients: a systematic review and meta-analysis.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2022Pooled it
- Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis.BMJ (Clinical research ed.) · 2021Pooled it
- Rapid antigen detection and molecular tests for group A streptococcal infections for acute sore throat: systematic reviews and economic evaluation.Health technology assessment (Winchester, England) · 2020Pooled it
- Group A Streptococcus pharyngitis and pharyngeal carriage: A meta-analysis.PLoS neglected tropical diseases · 2018Pooled it
- Influence of a guideline or an additional rapid strep test on antibiotic prescriptions for sore throat: the cluster randomized controlled trial of HALS (Hals und Antibiotika Leitlinien Strategien).BMC primary care · 2023Trial
- Antibiotics for lower respiratory tract infection in children presenting in primary care in England (ARTIC PC): a double-blind, randomised, placebo-controlled trial.Lancet (London, England) · 2021Trial
- Prevalence of Group AThe American journal of tropical medicine and hygiene · 2020Trial
- Delayed antibiotic prescribing strategies for respiratory tract infections in primary care: pragmatic, factorial, randomised controlled trial.BMJ (Clinical research ed.) · 2014Trial
- Management of Acute Sore Throat in Community Pharmacies: Insights from a Survey of Italian Pharmacists.Pharmacy (Basel, Switzerland) · 2026Article
- Article
- Article
- Antibiotics for lower respiratory tract infection in children presenting in primary care: ARTIC-PC RCT.Health technology assessment (Winchester, England) · 2023Article
- Post-consultation acute respiratory tract infection recovery: a latent class-informed analysis of individual patient data.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Article
- Role of multidimensional factors in the diagnosis and treatment of tonsillopharyngitis in primary care: a qualitative study.BMC primary care · 2022Article
- Article
- The aetiology of pharyngotonsillitis in primary health care: a prospective observational study.BMC infectious diseases · 2021Observational
- The Safety of Delayed Versus Immediate Antibiotic Prescribing for Upper Respiratory Tract Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Article
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16 authors at 6 institutions in 1 country.
Funding
Abstract
objectiveTo document whether elements of a structured history and examination predict adverse outcome of acute sore throat.
designProspective clinical cohort.
settingPrimary care.
participants14,610 adults with acute sore throat (≤ 2 weeks' duration).
main outcome measuresCommon suppurative complications (quinsy or peritonsillar abscess, otitis media, sinusitis, impetigo or cellulitis) and reconsultation with new or unresolving symptoms within one month.
resultsComplications were assessed reliably (inter-rater κ=0.95). 1.3% (177/13,445) of participants developed complications overall and 14.2% (1889/13,288) reconsulted with new or unresolving symptoms. Independent predictors of complications were severe tonsillar inflammation (documented among 13.0% (1652/12,717); odds ratio 1.92, 95% confidence interval 1.28 to 2.89) and severe earache (5% (667/13,323); 3.02, 1.91 to 4.76), but the model including both variables had modest prognostic utility (bootstrapped area under the receiver operator curve 0.61, 0.57 to 0.65), and 70% of complications (124/177) occurred when neither was present. Clinical prediction rules for bacterial infection (Centor criteria and FeverPAIN) also predicted complications, but predictive values were also poor and most complications occurred with low scores (67% (118/175) scoring ≤ 2 for Centor; 126/173 (73%) scoring ≤ 2 for FeverPAIN). Previous medical problems, sex, temperature, and muscle aches were independently but weakly associated with reconsultation with new or unresolving symptoms.
conclusionImportant suppurative complications after an episode of acute sore throat in primary care are uncommon. History and examination and scores to predict bacterial infection cannot usefully identify those who will develop complications. Clinicians will need to rely on strategies such as safety netting or delayed prescription in managing the uncertainty and low risk of complications.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.