Clinical performance and effect on treatment rates of latex agglutination testing for streptococcal pharyngitis in an emergency department.
Of 556 children with symptoms of streptococcal pharyngitis in a pediatric hospital emergency department, 38.8% had positive results on either a rapid latex agglutination test or throat culture for Group A Streptococcus. Twenty-six percent of patients with negative latex agglutination test results had growth on culture of a paired specimen. Under the best assumption rapid test sensitivity was 44.9%. The treatment rate (84%) for cases detected by the rapid test was markedly higher than the rate (44%) for cases detected only by culture (P less than 0.001), presumably because the rapid test result is available sooner. We conclude that: the rapid test had a lower sensitivity in routine use in our pediatric emergency department population than in previous reports from research settings; and using the rapid test in addition to culture can significantly increase treatment rates.
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007223:Infant; D007841:Latex Fixation Tests; D008297:Male; D010612:Pharyngitis / Q000175:diagnosis* / Q000188:drug therapy; D010614:Pharynx / Q000382:microbiology; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000276:immunology / Q000302:isolation & purification; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial