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.