Herziening van de NHG-standaard ‘Acute keelpijn’

• The aim of a diagnostic work-up in patients with acute sore throat is to exclude serious causes of tonsillitis and, in cases of a pharyngotonsillitis, to assess the degree of illness and the risk of complications.
• A diagnostic work-up aimed at the distinction between a viral or bacterial cause of pharyngotonsillitis does not determine initial treatment policy.
• Pharyngotonsillitis usually has a benign natural course; patient information and analgesia are usually sufficient treatment.
• Complications of an infection with group A streptococci are rare; diagnostic work-up for this bacterial cause is, therefore, not recommended.
• Antibiotics are only useful in cases of severe pharyngotonsillitis, increased risk of complications or a peritonsillar infiltration.
• The antibiotic of choice is a narrow spectrum penicillin; however, amoxicillin/clavulanate is indicated in patients with peritonsillar infiltration.
• If there is discrepancy in adults between the severity of symptoms and findings on physical examination, the possibility of epiglottitis should be considered.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.