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Rapid group A streptococcal antigen detection kit: effect on antimicrobial therapy for acute pharyngitis
S C Redd1, R R Facklam, S Collin
1Division of Bacterial Diseases, Centers for Disease Control, Atlanta, GA 30333.
Pediatrics
|October 1, 1988
Summary
Rapid diagnostic tests for group A streptococcal pharyngitis improved treatment for confirmed cases. However, limited sensitivity means some patients with non-streptococcal pharyngitis may still receive unnecessary antibiotics.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Group A streptococcal pharyngitis is common, particularly in certain populations.
- Appropriate antimicrobial use is crucial for managing streptococcal pharyngitis.
- Rapid diagnostic tests (RDTs) offer potential for timely diagnosis.
Purpose of the Study:
- To prospectively evaluate the use of RDTs for group A streptococcal pharyngitis.
- To measure the sensitivity and specificity of the RDT.
- To assess the impact of RDTs on physician prescribing patterns.
Main Methods:
- Prospective evaluation of RDTs in patients with pharyngitis.
- Measurement of RDT sensitivity (62.8%) and specificity (96.9%).
- Correlation of RDT use with changes in physician antimicrobial prescribing.
Main Results:
- Treatment of streptococcal pharyngitis increased from 36.5% to 72.5% during the study.
- Treatment of non-streptococcal pharyngitis remained unchanged.
- Physicians increasingly relied on clinical signs over negative RDT results.
Conclusions:
- RDTs with high specificity can improve early treatment of streptococcal pharyngitis.
- Limited RDT sensitivity necessitates further test development to avoid overtreatment.
- Improved negative predictive value is needed to prevent unnecessary antibiotic use.