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Diagnosis and Management of Group a Streptococcal Pharyngitis in the United States, 2011–2015
- Source :
- BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-9 (2019), BMC Infectious Diseases
- Publication Year :
- 2019
- Publisher :
- BMC, 2019.
-
Abstract
- Background 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. Methods 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. Results 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 2015 (0.06% vs 0.27%). Antibiotic use was frequent (49.3%), less often in combination with RADT plus culture (31.2%) or NAAT alone (34.5%) but significantly more often with RADT alone (53.4%) or no test (57.1%). Pediatricians were significantly less likely than other providers to prescribe antibiotics in their patients, regardless of patient age (p
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
Microbiological culture
Adolescent
medicine.drug_class
Streptococcus pyogenes
030106 microbiology
Antibiotics
Immunologic Tests
Acute Pharyngitis
Streptococcal pharyngitis
Group A
Drug Prescriptions
lcsh:Infectious and parasitic diseases
03 medical and health sciences
0302 clinical medicine
Medical microbiology
Internal medicine
Streptococcal Infections
Sore throat
Medicine
Humans
NAAT
lcsh:RC109-216
030212 general & internal medicine
Child
Diagnostics
Retrospective Studies
business.industry
Incidence (epidemiology)
Pharyngitis
United States
Anti-Bacterial Agents
Infectious Diseases
Practice Guidelines as Topic
Antibiotic use
Female
medicine.symptom
business
Nucleic Acid Amplification Techniques
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712334
- Volume :
- 19
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Infectious Diseases
- Accession number :
- edsair.doi.dedup.....bc107cfe8145ebac8ea9c3aeb7a2791e