The Effect of Rapid Antigen Detection Test on Antibiotic Prescription Decision of Clinicians and Reducing Antibiotic Costs in Children with Acute Pharyngitis

J Trop Pediatr. 2016 Aug;62(4):308-15. doi: 10.1093/tropej/fmw014. Epub 2016 Mar 15.

Abstract

We aimed to investigate the effect of rapid antigen detection test (RADT) in the diagnosis of streptococcal pharyngitis, its impact on antibiotic prescription decision of pediatricians and influence on reduction of antibiotic treatment costs in children with pharyngitis. The study group consisted of 223 patients who were diagnosed with pharyngitis by pediatricians. The sensitivity and specificity of RADT were 92.1% (95% Cl: 78.6-98.3%) and 97.3% (95% Cl: 93.8-99.1%), respectively. In the first assessment, before performing RADT, pediatricians decided to prescribe antibiotics for 178 (79.8%) patients with pharyngitis. After learning RADT results, pediatricians finally decided to prescribe antibiotics for 83 (37.2%) patients with pharyngitis, and antibiotic prescription decreased by 42.6%. Antibiotic costs in non-Group A streptococcus pharyngitis, Group A streptococcus pharyngitis and all subjects groups decreased by 80.8%, 48%, and 76.4%, respectively. Performing RADT in children with pharyngitis has an important impact on treatment decision of clinicians, reduction of unnecessary antibiotic prescriptions and antibiotic costs.

Keywords: Centor score; Group A streptococcus; antibiotic costs.; pharyngitis; rapid antigen detection test; throat culture.

MeSH terms

  • Acute Disease
  • Adolescent
  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Costs and Cost Analysis
  • Decision Making
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Fever / etiology
  • Humans
  • Immunologic Tests
  • Male
  • Pharyngitis / diagnosis*
  • Pharyngitis / drug therapy*
  • Pharyngitis / microbiology
  • Prospective Studies
  • Sensitivity and Specificity
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / drug therapy
  • Streptococcus pyogenes / isolation & purification*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents