Streptococcal Pharyngitis and Gram Stains

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To the editor: When the rising cost of health care appears insurmountable, seeing health professionals attempting to implement more cost-effective means of delivering health care is encouraging. In an article by Crawford and colleagues in the March 1979 issue (1) “Streptococcal Pharyngitis: Diagnosis by Gram Stains,” a cost-effective method of identifying group A streptococcal pharyngitis was proposed. The authors showed that the most cost-effective approach was when diagnostic methods were targeted to high-risk patients. Indeed, selective screening for streptococcal pharyngitis is supported by this country's low rate of acute rheumatic fever and rare occurrence of epidemic streptococcal disease (2). In

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