A patient has a sore throat and a negative rapid strep test. What should the next step be?

The appropriate next step for a patient presenting with a sore throat and a negative rapid strep test is to perform a throat culture. Despite a negative rapid strep test, there is still a possibility of streptococcal infection, as rapid tests are not 100% sensitive. A throat culture, although it takes longer to yield results, is more reliable and can confirm or rule out a streptococcal infection. This is particularly important to prevent complications associated with untreated streptococcal pharyngitis, such as rheumatic fever or post-streptococcal glomerulonephritis.

Resting and increasing fluid intake can help manage symptoms but does not address the underlying cause if an infection is present. Starting broad-spectrum antibiotics without clear evidence of a bacterial infection could contribute to antibiotic resistance and is not advisable based on current guidelines. Prescribing antibiotics solely based on rapid test results is also not recommended since a negative result suggests that an alternative diagnosis or treatment approach is necessary. Therefore, performing a throat culture is the most prudent step to ensure accurate diagnosis and appropriate management.