A Randomized Controlled Trial Comparing Phenoxymethylpenicillin and No Antibiotic Treatment for Group A Streptococci-Negative Acute Tonsillitis in Primary Care

What this Trial Is About

Researchers are studying sore throat, a common reason for antibiotic use in primary care, focusing on patients aged 15 years and older with sore throat symptoms but negative tests for group A streptococci (GAS). The trial aims to evaluate whether phenoxymethylpenicillin shortens the illness duration, reduces symptom severity, and decreases time off work or school. The study also explores the role of other bacteria and viruses in sore throat cases where GAS is not detected. Participants are randomly assigned to receive either oral phenoxymethylpenicillin tablets (1000 mg three times daily for 10 days) or no antibiotic treatment. There is also a reference group of patients with severe GAS-positive tonsillitis. Blood and throat samples are collected at the start and during follow-up to analyze inflammatory responses and identify bacteria or viruses present, including Fusobacterium necrophorum and streptococcal groups C and G. Participants keep a symptom diary for 10 days and return for a follow-up visit 18 to 24 days after starting the study to review clinical outcomes and repeat testing. Additional follow-up occurs via email at 1 and 3 months to monitor symptom resolution and recurrence. The main outcome measured is the number of days from study entry until symptoms resolve, along with other symptom and recovery assessments and monitoring for any adverse events.

Sore Throat in Primary Care - a Comparison of Phenoxymethylpenicillin and No Antibiotic Treatment