Patient with sore throat, abdominal pain/nausea, headache, fever, tender cervical lymphadenopathy and/or scarlatiniform rash*
Diagnostic Stewardship
Inappropriate testing leads to Unncessary Antibiotics
Prominent symptoms cough, runny nose, red eyes, hoarsness?
NO
Sores in mouth (>3 loose stools in a 24 hour period)?
NO
Under age 3 and no sick contacts with strep throat?
NO
Swab both tonsils and posterior pharynx*
Prominent symptoms cough, runny nose, red eyes, hoarsness?
YES
Do not swab throat*
NO
Sores in mouth (>3 loose stools in a 24 hour period)?
YES
Do not swab throat*
NO
Under age 3 and no sick contacts with strep throat?
YES
Do not swab throat*
NO
Swab both tonsils and posterior pharynx*
YES
YES
YES
Do not swab throat
*Diffuse erythema that blanches with pressure, with a “sandpaper” quality to the skin. It usually starts in the groin and armpits and is accompanied by circumoral pallor and a strawberry tongue. The rash is most marked in the skin folds of the inguinal axillary, antecubital, and abdominal areas and about pressure points.
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