[Streptococcal pharyngitis in the pediatric emergency department: value and impact of rapid antigen detection test].
The French Health Agency (Afssaps) recommands the resort to the streptocoque rapid test strip for a better targetting of antibiotics prescription.


OBJECTIVE
To evaluate the systematic use of the test in a pediatric emergengy department.


METHODS
Comparison of results of the test to the laboratory cultures. Our study took place between January and December 2004. Two thousand one hundred (and) forty-four children with acute pharyngitis have been included (mean age: 4.8+/-3.6 years).


RESULTS
Group A streptococcus was involved in 57 pharyngitis (26%). Mean age of children with positive culture was 7+/-3 years versus 4+/-3 years if culture was negative (p>0.05). The test sensitivity was 77% (CI 95%: 65-86) and its specificity 82% (CI 95%: 75-87), the positive predictive value was 60% (CI 95%: 49-71) and the negative predictive value 91% (CI 95%: 85-95). Antibiotic prescriptions have diminished: no prescription for 70% of pharyngitis and for 93% if cultures were negative.


CONCLUSIONS
The rapid test strip wide use has a strong repercussion on the antibiotics prescription. This test is realist in pediatric emergency unit.
Buchbinder
N
N
Service des urgences pédiatriques, hôpital Flaubert, groupe hospitalier, 55 bis, rue Gustave-Flaubert, 76600 Le Havre, France.
Benzdira
A
A
Belgaïd
A
A
Dufour
D
D
Paon
J-C
JC
Morel
A
A
Le Roux
P
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D004636:Emergency Service, Hospital; D006801:Humans; D010612:Pharyngitis / Q000188:drug therapy / Q000382:microbiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000276:immunology* / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial