Clinical utility of a new rapid test for the detection of group A Streptococcus and discriminate use of antibiotics for bacterial pharyngitis in an outpatient setting.
OBJECTIVE
To evaluate the clinical usefulness of the Diaquick Strep. A Test (SAT) as a rapid streptococcal antigen test, and its effect on antibiotic use in children.


METHODS
This was a prospective study of children with acute catarrh, fever, and acutely inflamed throat/tonsils. Paired throat swabs for SAT and culture were collected. None of the children received antibiotics prior to testing.


RESULTS
Five hundred and five children were included in the study: 278 were boys (55%) and 409 (81%) were aged under 5 years. The SAT was negative in 434 cases (86%) and positive in 71 (14%); culture was negative in 425 cases (84%) and positive in 80 (16%), including nine cultures that grew bacteria other than group A beta-hemolytic streptococci (GAS). Both the SAT and culture were negative in 422 cases (84%) and positive in 68 (13%), but were inconsistent in 15 cases (3%). For GAS infection, the SAT positive predictive value was 95.8% (68/71). The negative predictive value for the whole group as well as for children under five years of age was over 99% (422/425 and 355/358, respectively). SAT sensitivity was almost 96%. Finally, only 74 children (15%) were given antibiotics, while a staggering 431 (85%) were not.


CONCLUSIONS
The Diaquick Strep. A Test (SAT) is a quick, reliable, and clinically useful test, which could help to dramatically reduce the usage of antibiotics in children with fever, catarrh, and acute pharyngotonsillitis.
Al-Najjar
Fadil Y A
FY
Department of Pediatrics, Al-Zahra Hospital, Al-Zahra Square, PO Box 3499, Sharjah, United Arab Emirates. fadil2572@hotmail.com
Uduman
S A
SA
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D002855:Chromatography, Thin Layer / Q000379:methods; D003470:Culture Media; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D008297:Male; D010045:Outpatients; D010612:Pharyngitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D010614:Pharynx / Q000382:microbiology; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D003470:Culture Media; D011933:Reagent Kits, Diagnostic