The problem, the consequences, and rapid testing solutions
Acute pharyngitis constitutes a frequent cause of visits and prescribing of antibiotics in primary healthcare facilities.1 Although viruses cause most acute pharyngitis episodes, Streptococcus pyogenes (Group A Strep or GAS) causes 15-30% of cases.1
Prompt antibiotic therapy is associated with faster subsidence of symptoms, prevention of complications and reduced spread of the strain to others.1 In fact, if left untreated, serious sequelae such as rheumatic fever and glomerularnephritis may occur. However, the diagnosis of Strep A pharyngitis based on clinical features alone is unreliable even for experienced physicians.1,3 Although Strep A is the cause in only 15% - 30% of cases, antibiotics are prescribed in 55% - 75% of cases.1 Throat swab culture is the gold standard test but delays diagnosis for at least 18-72 hours.2
Delays in the diagnosis of pharyngitis often lead physicians to prescribe empirically without definitively identifying cases caused by Group A Strep.1 This causes an overuse of antibiotics that leads to an increase in antibiotic-resistant bacteria.4
Even the Centers for Disease Control and Prevention (CDC) recommend in pediatric patients to treat only proven Group A Strep, and that clinical findings alone do not adequately allow physicians to distinguish Strep from non-Strep pharyngitis.5
A young child arrives at your surgery with symptoms of pharyngitis. Her mother is insistent for a prescription. Which diagnostic pathway do you choose for you patient?
Rapid identification and consequent prompt treatment of patients with pharyngitis due to Strep A can reduce the risk of spread, can allow patients to return to school or work sooner, and may reduce the acute morbidity of this illness.6
ID NOW™ (formerly Alere™ i) is a revolutionary platform for the rapid, molecular detection of Infectious Diseases. ID NOW™ Strep A 2 is the latest test available and provides accurate results in 6 minutes or less, making it significantly faster than other molecular methods and more accurate7 than conventional rapid testing.
The combined accuracy and speed of ID NOW Strep A 2 enables you to deliver actionable results in allowing for the targeted use of antibiotics and antivirals in any healthcare setting.
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- Maltezou, H.C. et al. (2008) Evaluation of a rapid antigen detection test in the diagnosis of streptococcal pharyngitis in children and its impact on antibiotic prescription. Journal of Antimicrobial Chemotherapy, 62:1407–1412.
- Lasseter, G.M. et al. (2009) In vitro evaluation of five rapid antigen detection tests for group A beta-haemolytic Streptococcal sore throat infections. Family Practice, 1-8.
- Lin, M.H. et al. (2003) Epidemiological and clinical features of group A Streptococcus pharyngitis in children. Acta Paediatr Taiwan, 44(5):274-8.
- Regoli, M. et al. (2011) Update on the management of acute pharyngitis in children. Italian Journal of Pediatrics, 37:10.
- Poses R.M., Cebul .RD., Collins M., et al. The accuracy of experienced physicians’ probability estimates for patients with sore throat: implications for decision making. JAMA 1985 254:925-29. Available from: http://www.cdc.gov/getsmart/campaign-materials/info-sheets/child-pharyngitis.html
- Gerber, M.A. and Shulman, S.T. (2004) Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci. Clin Microbiol Rev. 2004 Jul; 17(3). Doi 10.1128/CMR.17.3.571-580.2004
- Lean, W.L. et al. (2014) Rapid Diagnostic Tests for Group A Streptococcal Pharyngitis: A Meta-analysis. Pediatrics. Pub online Sep 8, 10.1542/peds.2014-1094
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