Quote:
Originally Posted by Street Pharmacist
To add to what Machiavelli said, the standard protocol, that SHOULD be followed, is to swab first and prescribe upon results. All guidelines stress this. Even if presenting with all the clinical symptoms, only 70% are bacterial in nature, so swabs are necessary. Strep is a self limiting infection, it goes away by itself. The reason for treating with antibiotics is to prevent rare complications like rheumatic fever and resulting kidney damage. In and of itself, strep goes away on it's own
If the Doctor on the phone says "yep, is strep" there should be a prescription phoned in at that point. Really, it should have been phoned in the day he got the results. The problem wasn't the swab first, the problem is insisting on a visit to get the treatment
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Well, there's actually a clinical score that predicts the probability of Strep infection. If it's very high, as I suspect it was in Slava's son's case, the protocol should be to treat first.
Strep does eventually resolve, but if antibiotics are given within the first couple of days of symptom onset, the duration of symptoms can be shortened by up to 48 hours, which can be significant if the patient is really suffering. Treatment can also reduce the rate transmission to close contacts.
The kidney damage from post-streptococcal glomerulonephritis is actually one of the complications that has not been proven to be prevented by antibiotic treatment.