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Does it make sense to detect Streptococcus pyogenes during tonsillitis in Europe to prevent acute rheumatic fever?
[acute rheumatic fever]
French
health
authorities
constantly
publish
public
health
recommendations
,
and
ever
since
the
pay-for-performance
(
P
4
P
)
program
was
implemented
in
France
,
physicians
have
been
more
motivated
to
follow
them
[
1
]
.
Currently
,
guidelines
regarding
pharyngeal
infection
,
one
of
the
most
common
community-acquired
infections
[
2
]
,
recommend
the
use
of
a
Centor
clinical
scoring
system
to
identify
patients
with
high
probability
of
group
A
Streptococcus
(
GAS
)
pharyngitis
and
the
use
of
Rapid
Antigen
Tests
(
RATs
)
to
confirm
the
microbiological
diagnosis
[
3
]
.
Antibiotic
therapy
is
recommended
only
for
patients
with
microbiological
evidence
of
GAS
,
with
the
aims
of
reducing
the
duration
and
severity
of
clinical
symptoms
and
of
preventing
post-streptococcal
complications
.
The
public
health
objectives
of
these
guidelines
are
to
avoid
inappropriate
antibiotic
treatments
,
to
minimize
the
risk
of
antibiotic
resistance
,
and
to
limit
the
costs
of
pharmaceutical
expenditures
.
Despite
the
P
4
P
incentives
,
there
remained
some
risk-averse
physicians
who
prescribed
more
antibiotics
when
they
did
not
use
RATs
than
risk-tolerant
doctors
did
[
4
]
.
This
article
is
protected
by
copyright
.
All
rights
reserved
.
Diseases
Validation
Diseases presenting
"to minimize the risk of antibiotic resistance"
symptom
acute rheumatic fever
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