Archives de pediatrie : organe officiel de la Societe francaise de pediatrie · 2007
[Streptococcal pharyngitis in the pediatric emergency department: value and impact of rapid antigen detection test].
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Buchbinder N, Benzdira A, Belgaïd A, Dufour D, Paon J-C, Morel A, Le Roux P
Аннотация
UNLABELLED: The French Health Agency (Afssaps) recommands the resort to the streptocoque rapid test strip for a better targetting of antibiotics prescription.
OBJECTIVES: To evaluate the systematic use of the test in a pediatric emergengy department.
METHODS: 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).
RESULTS: Group A streptococcus was involved in 57 pharyngitis (26%). Mean age of children with positive culture was 7+/-3 years versus 4+/-3 years if culture was negative (p>0.05). The test sensitivity was 77% (CI 95%: 65-86) and its specificity 82% (CI 95%: 75-87), the positive predictive value was 60% (CI 95%: 49-71) and the negative predictive value 91% (CI 95%: 85-95). Antibiotic prescriptions have diminished: no prescription for 70% of pharyngitis and for 93% if cultures were negative.
CONCLUSION: The rapid test strip wide use has a strong repercussion on the antibiotics prescription. This test is realist in pediatric emergency unit.
OBJECTIVES: To evaluate the systematic use of the test in a pediatric emergengy department.
METHODS: 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).
RESULTS: Group A streptococcus was involved in 57 pharyngitis (26%). Mean age of children with positive culture was 7+/-3 years versus 4+/-3 years if culture was negative (p>0.05). The test sensitivity was 77% (CI 95%: 65-86) and its specificity 82% (CI 95%: 75-87), the positive predictive value was 60% (CI 95%: 49-71) and the negative predictive value 91% (CI 95%: 85-95). Antibiotic prescriptions have diminished: no prescription for 70% of pharyngitis and for 93% if cultures were negative.
CONCLUSION: The rapid test strip wide use has a strong repercussion on the antibiotics prescription. This test is realist in pediatric emergency unit.