Are antibiotics effective for adults and children with acute sore throats?

DATA SOURCES
Studies were identified by searching MEDLINE with the terms“pharyngitis,” “sore throat,” and “tonsillitis”; the Cochrane Library; the Cochrane Acute Respiratory Infections Group trials register; and bibliographies of included studies. Inclusion dates of the studies were 1945 through 1999.
STUDY SELECTION
Controlled trials were selected if they compared the use of antibiotics with that of placebo, if the patients had symptoms of acute sore throat and were in primary care settings, and if outcomes included the incidence of acute rheumatic fever within 2 months or of acute glomerulonephritis within 1 month; acute otitis media; acute sinusitis;quinsy (peritonsillar abscess); or symptoms of throat soreness, headache, or fever.
DATA EXTRACTION
Data were extracted or sought from the authors of trials on study quality; publication date; patient characteristics; and antibiotic therapy, including duration, outcomes, symptom resolution, and adverse effects.
MAIN RESULTS AND CONCLUSION
Twenty-two studies (10,484 cases of sore throat) met the inclusion criteria. Most were done in the 1950s, although 4 were published recently (1996 through 1999). Analyses of all antibiotic use together and only trials of penicillin showed reductions in the incidence of acute rheumatic fever; antibiotics also reduced the incidence of acute otitis media, quinsy, and symptoms of fever, throat soreness, and headache at day 3 (table). Antibiotic use did not prevent acute glomerulonephritis within 2 months or sinusitis within 14 days. Subgroup analyses showed that these results were not changed when blinding, use of antipyretics, confirmed streptococcal infections, or age of the patients were analyzed. Data were insufficient to report on adverse effects. In patients with acute sore throat, antibiotics are effective for reducing symptoms of throat soreness, fever, and headache at day 3 and the incidence of rheumatic fever, otitis media, and quinsy