Strep throat pediatric emergencies: impact and performance of a rapid diagnostic testPosted: April 6, 2012
Afssaps recommends the systematic use of rapid diagnostic test for streptococcus A in order to better target antibiotic prescribing.
We evaluated this test in a pediatric emergency department versatile.
We compared, for each diagnosed angina, the test result to that of culture and have included 216 patients (mean age: 4.8 ± 3.6 years) from January to December 2004.
We identified 57 bacterial tonsillitis (26%). Children with bacterial angina were aged 7 ± 3 years vs 4 ± 3 years for children whose culture was negative (p> 0.05). Test sensitivity was 77% (95% CI: 65-86) and a specificity of 82% (95% CI: 75-87). The PPV was 60% (95% CI: 49-71) and NPV of 91% (95% CI: 85-95). Predictive values of the test were influenced by the age of the child. The use of the test has prevented 70% of antibiotic prescriptions “useless”, especially in 93% of non streptoccociques angina. Prescribers followed the TDR result in 93% of cases.
The use of the test has a strong impact on antibiotic prescribing. It can begin early targeted treatment. The test lacks sensitivity, especially in older children. Its interpretation must be critical and consider the presentation and age of the child.
The French Health Agency (Afssaps) recommands the resort to the rapid strep test strip for a better targetting of prescription antibiotics.
To Evaluate the systematic use of the test in a pediatric department emergengy.
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).
Group A streptococcus pharyngitis WAS Involved in 57 (26%). Mean age of children with positive culture, WAS 7 ± 3 years vs 4 ± 3 years if WAS Culture negative (p> 0.05). The sensitivity test WAS 77% (95% CI: 65-86) and Its 82% specificity (95% CI: 75-87), the positive predictive value 60% WAS (95% CI: 49-71) and the negative predictive value 91% (95% CI: 85-95). Have Diminished antibiotic prescriptions: no prescription for 70% of pharyngitis and for 93% if negative cultures Were.
The rapid test strip wide use HAS strong repercussions on the prescription antibiotics. This test is realist in pediatric emergency unit.