Impact on empiric treatment of group A streptococcal pharyngitis using an optical immunoassay

The potential impact of using a rapid diagnostic test (Strep A OIA) on detection and treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis in a large-volume pediatric and adolescent clinic was examined. Of 519 swabs processed for both culture and the OIA test, 114 were culture-positive for GABHS compared with 133 positive by the OIA test, for an agreement of 94%. OIA test sensitivity compared with culture was 96%, and specificity was 94%. Forty-seven percent of all study patients were empirically placed on antibiotics. In-clinic OIA testing could have reduced inappropriate therapy and been a cost-effective alternative to culture.