Association Between Rapid Antigen Testing and Antibiotic Use and Accuracy of Peripheral Blood Parameters in Detecting Group A Streptococcus in Children With Tonsillopharyngitis

Abstract

Objectives: To investigate the effect of rapid antigen testing (RAT) on the practice of antibiotic prescription as well as the accuracy of peripheral blood neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) values in detecting group A beta-hemolytic Streptococcus (GABHS) in children with tonsillopharyngitis. Methods: In a multicenter study performed in Turkey, we retrospectively analyzed data from 668 consecutive pediatric patients under 17 years of age, who presented with signs and symptoms of tonsillopharyngitis and underwent RAT. The rates of positive and negative RAT results were determined and patients' antibiotic prescriptions were examined in relation to RAT results. In addition, the accuracy of peripheral blood NLR and CRP values was examined for 212 patients whose laboratory data were available, with RAT as the reference standard. Results: Positive RAT results were observed in 190 of 668 (28.4%) patients. Antibiotics were prescribed to all 190 patients with positive RAT results and to 8 of 478 patients with negative RAT results. Overall, the rate of antibiotic prescription was 29.6%. Patients with positive and negative RAT results did not differ significantly with regard to NLR and CRP values. In ROC analysis, the area under the ROC curve (AUC) of NLR and CRP were 0.54 (95% confidence interval [CI] 0.45–0.64), and 0.55 (95% CI 0.45–0.65), respectively. Conclusion: RAT results proved highly associated with antibiotic prescribing, suggesting that RATs could be of great value in preventing unnecessary antibiotic use. Our findings also suggest that NLR and CRP are poorly accurate to identify GABHS in children with tonsillopharyngitis.

Diagnostic value of platelet indices in infected nonunion: a retrospective study

“…Inflammation and infection are important regulators of coagulation and fibrinolytic system activity [ 22 , 23 ]. Because coagulation-related parameters such as fibrinogen, D-dimer, and platelet indices are easily measured in the clinic, many researchers have examined their diagnostic values in different infectious and inflammatory conditions [ 24 – 26 ]. Numerous studies have shown that fibrinogen, D-dimer, and platelet indices are associated with PJI [ 18 , 27 – 31 ].…”

A Retrospective Comparison Of Platelet Indices For Diagnosing Infected Nonunion

“…It is well known that in ammation and infection are important regulators of coagulation and brinolytic system activity [22,23]. Considering the easy measurement method by automatic blood counter devices, various studies were conducted to investigate the role of coagulation-related parameters, brinogen, Ddimer and platelet indices (PC, PCT, MPV, PDW, and PC/MPV) in the diagnosis of various infectious or in ammatory conditions [24][25][26]. Until now, numerous studies have evaluated the performances that brinogen, D-dimer and platelet indices play in diagnosis of PJI, and most of these studies proved that brinogen, D-dimer and platelet indices were associated with PJI [27-29, 18, 30, 31].…”

Evaluación de adherencia a la guía de práctica clínica para el manejo de faringoamigdalitis aguda en la atención de urgencias del Hospital Universitario San Ignacio, Bogotá, Colombia

“…Con base en estos hallazgos y criterios epidemiológicos, se han desarrollado escalas o puntajes, como los criterios de Paradise, la escala Fever-PAIN y de Centor modifi cados (1,6,7). Según las guías de práctica clínica de la Sociedad Americana de Enfermedades Infecciosas (Infectious Diseases Society of America, IDSA), se recomienda fuertemente la realización de la prueba de detección rápida de antígeno +/cultivo, excepto en pacientes cuya clínica oriente claramente hacia una etiología viral y en menores de tres años, donde el riesgo de faringoamigdalitis por SBHGA y fi ebre reumática es muy bajo (8).…”