The interest of a test for angina

Most sore throats are caused by viruses, yet these diseases have long been routinely treated with antibiotics effective only against bacteria. Today, a simple test can already differentiate between bacterial pharyngitis viral pharyngitis and thus reduce the number of inappropriate prescriptions.


Response to viral infections, drugs (like aspirin) have an interest to make the illness more bearable, by reducing pain or fever. However, antibiotics have no effect against viruses. A rapid test can now avoid these unnecessary prescriptions.

A test to identify streptococcal pharyngitis
Antibiotics do not shorten the evolution of a viral sore throat and do not relieve symptoms. They are not effective, either, to prevent bacterial superinfection. Their requirement is therefore, usually, no interest.
Today, a rapid test can identify tonsillitis caused by beta-hemolytic streptococcus group A (GAS). This test of bacteriological diagnosis of streptococcal sore throat (TDR) to detect a specific antigen of the bacterium responsible for most serious complications of angina, such as rheumatic fever (RAA). Very easy to use, these tests help to know in 5 minutes if angina is associated with streptococcus. A levy on the amygdala done with a swab (sort of long cotton swab) is plunged in a reagent that will change color.

Specifically:

TDR is negative: Angina is viral
All ages, most sore throats are viral and do not require antibiotics.

TDR is positive: Angina is streptococcal (GAS)
The recommended treatment is the first-line amoxicillin (except in cases of allergy) for 6 days.

The test sensitivity above 90% and specificity was 95%.

A book that this diagnostic test for angina?
The implementation of such a test is recommended

For children over 3 years before angina red (erythematous) or white dots (erythemato-pultaceous);
In adults with sore throat or red with white dots, with a risk of bacterial infection (risk assessed by the score of Mac Isaac based on symptoms and patient age).
Within three years, the test is unnecessary because tonsillitis are almost always viral. Despite a negative test, some patients at higher risk of acute articular rheumatism (AAR) - a personal history of AAR, were subjects of group A streptococcal pharyngitis repeatedly, returning from endemic countries, etc.. - Will be offered a throat swab to fully ensure the absence of streptococci.

 

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