Dutch researchers identified 156 children aged 4-15 who visited their family doctor with a severe sore throat. The children were randomly assigned to penicillin for seven days, penicillin for three days followed by placebo for four days, or placebo for seven days.

Penicillin did not reduce the duration of symptoms, nor did it affect school attendance or recurrences of sore throat.

Penicillin may, however, reduce the development of complications, such as quinsy or scarlet fever. Although, once a complication is diagnosed, sufficient time is left to start antibiotic treatment, say the authors.

The authors advocate prudent prescription behaviour with respect to penicillin. General practitioners should treat children with an acute sore throat only when they are severely ill or are at high risk of developing serious complications, they conclude.

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Contact: Emma Dickinson
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BMJ-British Medical Journal
4-Dec-2003