LAUSR

1. In the context of a Centor score 3–4 (McIsaac 3–4 or FeverPain 3–5), the authors suggest that ‘patients should be assured of an adequate dose of paracetamol. If this is not done, fast-acting paracetamol should be administered in the clinic (with an effect within 15–30minutes). In case of a poor or moderate effect, a throat swab should be obtained and analysed on the spot for the presence of GAS. Antibiotics may be considered if the test is positive.’ It seems that this approach will not be used in most countries and is not very realistic because it is timeconsuming, not feasible in a busy practice, incurs the cost of a rapid test and the illness is self-limiting in 95% of cases. Exceptional cases, such as immunocompromised or very sick patients, may benefit from antibiotics.