QuestionSBA
QuestionChoice
NICE recommends a delayed/backup antibiotic prescription if the FeverPAIN score is 2 or 3. This patient's FeverPAIN score is 1, making supportive management more appropriate.
10035450
d
Delayed antibiotic prescription
QuestionChoice
This patient likely has viral pharyngitis; his FeverPAIN score is 1 (for the absence of a cough), meaning that it is unlikely his symptoms are caused by a streptococcal infection. Clarithromycin would be a reasonable choice given his penicillin allergy if his FeverPAIN score was 4 or 5 (or his Centor score was 3 or 4)
10035449
c
Clarithromycin
QuestionChoice
This patient likely has viral pharyngitis; his FeverPAIN score is 1 (for the absence of a cough), meaning that it is unlikely his symptoms are caused by a streptococcal infection. He should be advised to rest and use regular analgesia, but to seek medical advice if his symptoms worsen.
10035447
a
Supportive management
QuestionChoice
This patient likely has viral pharyngitis; his FeverPAIN score is 1 (for the absence of a cough), meaning that it is unlikely his symptoms are caused by a streptococcal infection. Antibiotics are not currently indicated as per NICE guidelines. Phenoxymethylpenicillin would be an appropriate first choice in most cases, however this patient has an allergy to penicillin.
10035448
b
Phenoxymethylpenicillin
QuestionChoice
This patient likely has viral pharyngitis. There are no current indications for a referral to secondary care such as airway compromise or significant systemic upset.
10035451
e
Referral to secondary care
QuestionComment
I swear everytime pharyngitis comes up it's a toss up as to whether they're gonna use FeverPAIN or CENTOR. Wish NICE would just recommend one and one only.
58659
User
subscriber
Relapse Retrograde
Concept
Chapter
2693
4332
Streptococcal sore throat
Topic
194
Infectious Diseases
19493
Viral pharyngitis is common in adolescents; supportive management with rest and analgesia is typically sufficient, as antibiotics are ineffective.
A 14-year-old male has had a sore throat for four days, which is causing him pain when eating. He visits his GP asking for antibiotics to treat his symptoms. He is allergic to penicillin and has a past medical history of recurrent otitis externa. He denies any other symptoms.

On examination, his pharynx is red and inflamed and there is no palpable lymphadenopathy. An ear examination is normal. Observations are within normal limits.

What is the most appropriate course of action?
a