Limerick version of guideline on acute pharyngitis

This limerick is based on the Infectious Diseases Society of America’s Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis.


Whom do you test for Group A Strep?

To avoid treating strep carriers (a misstep!)

In kids under 3 don’t bother

Unless a sister or a brother

Has symptoms and a test that say yep.


In most children with acute pharyngitis

The cause is truly a virus

So if they have rhinorrhea,

Cough, ulcers or diarrhea,

Then don’t test for strep in situs.


For tho’ treating might make parents merrier

One in five kids is a strep carrier

So treating viral coxsackie

With penn or amoxi

Might cause resistant strep–that’s scarier!


If your history, exam and test

Confirm strep as the pharyngeal pest

Then amox or penn work magic

Or first-gen ceph if allergic

Then clinda or a macrolide are third-best.






Published by Marion Sills

I am a Professor of Pediatrics and Emergency Medicine at the University of Colorado. I work as a physician in the emergency departments of the Children's Hospital of Colorado and as a health services researcher at the University's Adult and Child Consortium for Health Outcomes (ACCORDS).

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