Sure. And when they're, you know, ten, with a sore throat, some cervical lymph node tenderness, no cough, no tonsillar exudates? In other words, every case of s

Sure. And when they're, you know, ten, with a sore throat, some cervical lymph node tenderness, no cough, no tonsillar exudates? In other words, every case of sore throat that walks in the door? 1/5 chance it's Group A strep and worth throwing abx at. And... then what? We know the stats, we have a non-specific presentation, and the traditional reason to throw abx at this patient is because we want to minimize the chance of a subsequent heart or kidney disease (post-infectious immune hypersensitivity rxn). 4/5 chance they don't need abx; 1/5 chance that they'll benefit, but not a lot. But, hey,... how do you even attach a utility analysis to "and a small reduction in the likelihood of heart and/or kidney damage"? The magnitude of the risk is hard to comprehend, subjectively, in the face of the small reduction in incidence. And you will see those consequences play out; you're going to see so many sore throats that the small odds will manifest. This isn't one of those, "stupid doctors, they don't know what they're doing!" things. It's something that doesn't readily yield to utility metrics.