BACKGROUND: Excessive antibiotics use increases the risk of resistance. Previous 
studies have shown that the Centor score combined with Rapid Antigen Detection 
Test (RADT) for Group A Streptococci can reduce unnecessary antibiotic 
prescribing in patients with sore throat. According to the former Swedish 
guidelines RADT was recommended with 2-4 Centor criteria present and antibiotics 
were recommended if the test was positive. C- reactive protein (CRP) was not 
recommended for sore throats. Inappropriate use of RADT and CRP has been 
reported in several studies.
METHODS: From a larger project 16 general practitioners (GPs) who stated 
management of sore throats not according to the guidelines were identified. 
Half-hour long semi-structured interviews were conducted. The topics were the 
management of sore throats and the use of near-patient tests. Qualitative 
content analysis was used.
RESULTS: The use of the near-patient test interplayed with the clinical 
assessment and the perception that all infections caused by bacteria should be 
treated with antibiotics. The GPs expressed a belief that the clinical picture 
was sufficient for diagnosis in typical cases. RADT was not believed to be 
relevant since it detects only one bacterium, while CRP was considered as a 
reliable numerical measure of bacterial infection.
CONCLUSIONS: Inappropriate use of near-patient test can partly be understood as 
remnants of outdated knowledge. When new guidelines are introduced the 
differences between them and the former need to be discussed more explicitly.