Diagnosis and Management of Group a Streptococcal Pharyngitis in the United States, 2011-2015

BMC Infectious Diseases
Robert LuoMatthew Thompson

Abstract

Clinical guidelines for the diagnosis of group A streptococcal (GAS) pharyngitis recommend the use of a rapid antigen detection test (RADT) and/or bacterial culture. This study evaluated the overall diagnosis and treatment of acute pharyngitis in the United States, including predictors of test type and antibiotic prescription. A retrospective analysis of pharyngitis events from 2011 through 2015 was conducted using the MarketScan commercial/Medicare databases. A pharyngitis event was defined as occurring within 2 weeks from the index visit. Patient and provider characteristics were examined across 5 testing categories: RADT, RADT plus culture, other tests, nucleic acid amplification testing (NAAT), and no test. Multivariate models were used to identify significant predictors of NAAT use and antibiotic prescription. A total of 18.8 million acute pharyngitis events were identified in 11.6 million patients. Roughly two-thirds of events (68.2%) occurred once, and roughly a third of patients (29.1%) required additional follow-up, but hospitalization was rare (0.3%). Across all events, 43% were diagnosed by RADT, while 20% were diagnosed by RADT plus culture. The proportion of events diagnosed by NAAT increased 3.5-fold from 2011 to ...Continue Reading

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Citations

Mar 13, 2020·Journal of Clinical Microbiology·Thomas Z Thompson, Allison R McMullen
Jun 5, 2020·The Cochrane Database of Systematic Reviews·Jérémie F CohenMartin Chalumeau
Nov 13, 2020·Frontiers in Cellular and Infection Microbiology·Zahid Mustafa, Masoumeh Ghaffari
Nov 1, 2020·Antibiotics·Sabiha EssackAdrian Shephard
May 9, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Constance DuboisJérémie F Cohen
May 27, 2021·International Journal of Pediatric Otorhinolaryngology·Edouard SayadAlexandre E Malek
Aug 22, 2021·Pediatric Emergency Care·Jennifer M ThompsonJoseph L Arms

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Methods Mentioned

BETA
nucleic acid amplification
PCR

Software Mentioned

SAS
MarketScan

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