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Positions and Practice

TREATMENT OF STREP PHARYNGITIS
WHEREAS Strep Pharyngitis (Beta-hemolytic Streptococcal Infection) is a common infectious disease that is associated with an increased risk of nonsupperative poststreptococcal syndromes (rheumatic fever, and poststreptococcal glomerulonephritis) in susceptible individuals;

WHEREAS several factors significantly increase an individual's risk of developing poststreptococcal syndromes, and the majority of such sequelae occur in individuals with a family history of rheumatic fever, a long duration of illness, other severe illnesses, a compromised immune system, crowded living conditions, and poor nutritional status;

WHEREAS throat cultures yield group A Streptococci in only 10% of individuals presenting clinically with a sore throat, and as much as 10-25% of the general population are asymptomatic carriers of group A Streptococci, and controlled clinical trials show that clinical recovery in similar cases is similar, with or without the use of antibiotics, and antibiotic administration does not reduce incidence of poststreptococcal glomerulonephritis, and a significant decrease in the incidence of rheumatic fever began before the introduction of penicillin, due to the improvement of socioeconomic, hygienic, and nutritional factors, and penicillin fails to be effective in as much as 20% of cases, and since such antibiotic therapy is estimated to cause 1.5 deaths per 100,000 doses;

WHEREAS naturopathic physicians are well trained in the standard clinical and laboratory diagnosis of Strep pharyngitis, and have been successfully treating Strep pharyngitis with very low incidence of poststreptococcal sequelae, using various natural antibiotics, and natural immune enhancing therapies, for close to one hundred years, and the current incidence of poststreptococcal sequelae is 0.4 to 2.8% for rheumatic fever and 0.2 to 20% for glomerulonephritis;

THEREFORE LET IT BE RESOLVED that it the position of the American Association of Naturopathic Physicians that:

I. All patients with signs and symptoms suggesting Beta-hemolytic Streptococcal infection should receive a thorough evaluation including an assessment of risk factors associated with poststreptococcal syndromes, and be informed of both conventional and naturopathic treatment options and their risks if any, as well as the potential risks of sequelae to group A Strep infection.

II. The use of antibiotics should be reserved for those patients who are unresponsive to naturopathic modalities and are not making significant improvement in a timely manner (i.e. no response after one week of naturopathic therapy).


Principal Author: Clark Hansen, ND
Adopted at the 1992 AANP Annual Convention.


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