Rapid Group a Streptococcus Antigen Test (Radt) Usage and Expediency in Diagnosis and Treatment of Pharyngotonsillitis in Family Physician Practice

Abstract

Background. Group A streptococcus (S. pyogenes) is responsi- ble for 5 – 20% of cases of pharyngitis in adults and 15 to 20% of cases in children. Most common diagnostic tests are throat culture and rapid antigen detection testing (RADT). The modified Centor criteria can be used to help physicians decide which patients need no testing, throat culture/rapid antigen detection testing or empiric antibiotic therapy. Objective. Evaluate the rapid group A streptococcus antigen test (RADT) usage and expediency in family physician practice. Goals. To analyze children aged between 3 - 15 who suffers from acute pharyngitis ≥ 3 times per year and have ≥ 3 modified Centor criteria; to evaluate the ease of use of RADT in family phy- sician practice; to identify the correlation between RADT and the clinical symptoms of the acute pharyngitis and between the RADT and the blood test results; to evaluate the importance of RADT in diagnosing the acute pharyngitis and choosing treatment strategy. Methods. The study was accomplished in 2011-2013. 108 children aged between 3 and 15 and who suffers from acute pha- ryngitis > 2 times per year, plus have ≥ 3 modified Centor criteria were investigated. Prospectively all patients were tested by RADT. Also, the prescribed treatment and its effectiveness were analyzed. Statistical facts analysis was performed by using „SPSS 17.0“ and „MS Excel“ programs. Results. Girls suffer more often than boys from acute pha- ryngotonsillitis. The age average of patients was 7,22 ± 3,532. On average, patients appealed to doctor after 2-3 days of illness. RADT was positive in 32 (29.6%) children. Moreover, RADT was more often positive (42%) for children in 7-10 years old group, also for children who had 5 modified Centor criteria (62% of all positive cases). Conclusion. No statistically significant difference was obtained between the clinical symptoms and treatment effectiveness for children with a positive or negative result in RADT. However, all patients with positive RADT and who were taking Phenoxymethyl- penicillin recovered in 10 days. Moreover, obtained data shows that RADT test will facilitate the correct diagnosis and the tactics of selecting the treatment.