Abstract
Objectives. Our aim was to identify a group of patients with clinical signs of tonsillitis to whom antibiotics could be prescribed without further diagnostic actions, and to compare the outcome of clinical assessment with the result of an antigen detection test using culture as the gold standard.
Methods. During two winter months, patients aged >=4 years attending for sore throat at three primary health care centres in Malmö, Sweden, were examined. Odds ratios, sensitivities, specificities and predictive values were calculated for clinical assessment and for an antigen detection test.
Results. Among the 169 participating patients, growth of group A ß-haemolytic streptococci (GAS) was found in 53 cultures, and 23 patients (14%) were clinically assessed as ‘absolutely positive’, representing positive clinical assessment. Nineteen had positive cultures for GAS. The sensitivity, specificity and predictive positive and negative value for the antigen detection test were 82, 96, 90 and 93%, respectively, and for positive clinical assessment 36, 97, 83 and 77%.
Conclusion. It is possible to identify a small group of patients with convincing signs of tonsillitis in which the specificity as well as the predictive positive value of the rapid test and the clinical assessment are close to equal. Antibiotics may be prescribed to these patients without further diagnostic actions.
Keywords. Antigen detection test, clinical assessment, rapid te
Methods. During two winter months, patients aged >=4 years attending for sore throat at three primary health care centres in Malmö, Sweden, were examined. Odds ratios, sensitivities, specificities and predictive values were calculated for clinical assessment and for an antigen detection test.
Results. Among the 169 participating patients, growth of group A ß-haemolytic streptococci (GAS) was found in 53 cultures, and 23 patients (14%) were clinically assessed as ‘absolutely positive’, representing positive clinical assessment. Nineteen had positive cultures for GAS. The sensitivity, specificity and predictive positive and negative value for the antigen detection test were 82, 96, 90 and 93%, respectively, and for positive clinical assessment 36, 97, 83 and 77%.
Conclusion. It is possible to identify a small group of patients with convincing signs of tonsillitis in which the specificity as well as the predictive positive value of the rapid test and the clinical assessment are close to equal. Antibiotics may be prescribed to these patients without further diagnostic actions.
Keywords. Antigen detection test, clinical assessment, rapid te
| Original language | English |
|---|---|
| Pages (from-to) | 108-111 |
| Journal | Family Practice |
| Volume | 20 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2003 |
Bibliographical note
The information about affiliations in this record was updated in December 2015.The record was previously connected to the following departments: Division of Social Medicine and Global Health (013241820), Psychiatry/Primary Care/Public Health (013240500)
Subject classification (UKÄ)
- Family Medicine
Free keywords
- Antigen detection test
- clinical assessment
- rapid test
- streptococci
- throat culture
- throat infection
- tonsillitis