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
The Problem
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
The Consequences
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
