Don’t routinely do a throat swab when children present with a sore throat if they have a cough, rhinitis, or hoarseness as they almost certainly have viral pharyngitis.

When children with a sore throat present symptoms strongly suggestive of viral illness, such as a runny nose (rhinorrhea), cough or a hoarse voice, a throat swab is unlikely to change management, as these children seldom have ‘Strep Throat’ as the cause of their sore throat.

 

Sources:

Ebell MH, et al. The rational clinical examination. Does this patient have strep throat? JAMA. 2000 Dec 13;284(22):2912-8. PMID: 11147989.

Shulman ST, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov 15;55(10):1279-82. PMID: 23091044.

Tanz RR, et al. Performance of a rapid antigen-detection test and throat culture in community pediatric offices: implications for management of pharyngitis. Pediatrics. 2009 Feb;123(2):437-44. PMID: 19171607.