Reflexive Culture in Adolescents and Adults With Group A Streptococcal Pharyngitis

Dingle, Tanis C.; Abbott, April N.; Fang, Ferric C.

doi:10.1093/cid/ciu400

Cited by 38 publications

(25 citation statements)

References 31 publications

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“…However, despite the fact that the use of these rapid antigen detections tests reduces the percentage of antibiotics prescribed, some recent papers cast doubts on the clinical benefit of their use. In a retrospective analysis of 726 patients, post-streptococcal complications were observed in a substantial number of patients with negative results, thereby limiting the usefulness of this rapid point-of-care test [Dingle et al 2014]. We clearly need new rapid diagnostic instruments that allow clinicians to make a rapid decision on the basis of their results [Laxminarayan et al 2013].…”

Section: Promoting the Use Of Valid Point-of-care Testsmentioning

confidence: 99%

Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem

Llor

Bjerrum

2014

Therapeutic Advances in Drug Safety

1,334

929

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Antimicrobial resistance is a global public health challenge, which has accelerated by the overuse of antibiotics worldwide. Increased antimicrobial resistance is the cause of severe infections, complications, longer hospital stays and increased mortality. Overprescribing of antibiotics is associated with an increased risk of adverse effects, more frequent re-attendance and increased medicalization of self-limiting conditions. Antibiotic overprescribing is a particular problem in primary care, where viruses cause most infections. About 90% of all antibiotic prescriptions are issued by general practitioners, and respiratory tract infections are the leading reason for prescribing. Multifaceted interventions to reduce overuse of antibiotics have been found to be effective and better than single initiatives. Interventions should encompass the enforcement of the policy of prohibiting the over-thecounter sale of antibiotics, the use of antimicrobial stewardship programmes, the active participation of clinicians in audits, the utilization of valid rapid point-of-care tests, the promotion of delayed antibiotic prescribing strategies, the enhancement of communication skills with patients with the aid of information brochures and the performance of more pragmatic studies in primary care with outcomes that are of clinicians' interest, such as complications and clinical outcomes.

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Section: Promoting the Use Of Valid Point-of-care Testsmentioning

confidence: 99%

Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem

Llor

Bjerrum

2014

Therapeutic Advances in Drug Safety

1,334

929

View full text Add to dashboard Cite

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“…11 Nevertheless, not only are these tests of no use in ruling out causes other than GABHS, but it was observed in a recent study that they do not prevent the onset of complications when their results are false-negative. 33 For these reasons, it is necessary to continue to research new, more reliable, rapid diagnostic tests in order to help the primary care physician in making a clearer decision as to whether or not to treat an AP with antibiotics. 34…”

Section: Microbiological Methodsmentioning

confidence: 99%

Recommendations for Management of Acute Pharyngitis in Adults

Cots

Alós

Bárcena

et al. 2015

Acta Otorrinolaringologica (English Edition)

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Acute pharyngitis in adults is one of the most common infectious diseases seen in general practitioners' consultations. Viral aetiology is the most common. Among bacterial causes, the main agent is Streptococcus pyogenes or group A ␤-haemolytic streptococcus (GABHS), which causes 5%---30% of the episodes. In the diagnostic process, clinical assessment scales can help clinicians to better predict suspected bacterial aetiology by selecting patients who should undergo a rapid antigen detection test. If these techniques are not performed, an overdiagnosis of streptococcal pharyngitis often occurs, resulting in unnecessary prescriptions of antibiotics, most of which are broad spectrum. Consequently, management algorithms that include the use of predictive clinical rules and rapid tests have been set up. The aim of the treatment is speeding up symptom resolution, reducing the contagious time span and preventing local suppurative ଝ Please cite this article as: Cots JM, Alós JI, Bárcena M, Boleda X, Cañada JL, Gómez N, et al. Recomendaciones para el manejo de la faringoamigdalitis aguda del adulto. Acta Otorrinolaringol Esp. 2015;66:159---170.

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“…A). Sin embargo, hay otros gérmenes que producen faringoamigdalitis indistinguible clínicamente de la producida por EBHGA y que serían estreptococos A negativos (S. dysgalactiae, F. necrophorum, S. anginosus), por lo que en artículos recientes se hace referencia a que un porcentaje no despreciable de adultos con faringoamigdalitis, en los que el estreptococo A ha resultado negativo, podría beneficiarse de tratamiento antibiótico porque el cultivo faríngeo ha resultado positivo, siendo de utilidad igualmente los criterios clínicos expuestos anteriormente 16 .…”

Section: Métodos Diagnósticosunclassified

Tratamiento empírico de las infecciones del adulto

Mira

Sales

Domingo³

et al. 2016

FMC - Formación Médica Continuada en Atención Primaria

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Reflexive Culture in Adolescents and Adults With Group A Streptococcal Pharyngitis

Abstract: Reflexive GAS culture is clinically useful when RADTs are negative. RADTs fail to detect a substantial number of adult patients with clinically significant pharyngitis who can benefit from treatment.

Cited by 38 publications

References 31 publications

Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem

Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem

Recommendations for Management of Acute Pharyngitis in Adults

Tratamiento empírico de las infecciones del adulto

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