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Bisno and colleagues highlight the rationale for our study,¹ though we believe they draw attention away from the major problem in the treatment of adults with pharyngitis by focusing on patients meeting 4 Centor criteria. In our study, these patients made up only 2% of the sample and accounted for only 4% of antibiotic prescribing. Bisno and colleagues have written that "adults who meet none or only 1 of the 4 Centor criteria should not be tested or treated because of the very low probability of streptococcal infection, "^2(p127) a statement that agrees with the ACP guideline. Management of these patients is the major problem, having accounted for 57% of testing and 44% of antibiotic prescribing.

Westerman raises several seemingly controversial issues regarding the evaluation of adults with pharyngitis. Group C and G streptococci can cause pharyngitis that mimics GAS pharyngitis. However, group C and G streptococcal pharyngitis . . . [Full Text of this Article]

AUTHOR INFORMATION
Jeffrey A. Linder, MD, MPH; David W. Bates, MD, MSc

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