To the Editor: I read with much interest the article by Markowitz on "Cultures of the Respiratory Tract in Pediatric Practice" in the January issue. As a practicing pediatrician I welcome any rational approach to the use or nonuse of antibiotics in the treatment of respiratory infections. Unfortunately, this article has not presented any easier approach. The breaking down of cultures of the throat and nasopharynx into a variety of organisms is unnecessarily complex.
It is generally recognized that there are only two bacterial agents capable of causing acute pharyngitis, the β-hemolytic streptococcus and the diphtheria bacillus.1 The large majority of pharyngitides are of viral origin. Therefore, the problem is to decide whether a virus or the β-hemolytic streptococcus is the causative agent (diphtheria has been omitted because of its rarity and its relative ease of recognition on clinical grounds).
Complications following a viral pharyngitis are not necessarily due