Clinical Impact of a Rapid Streptococcal Antigen Test on Antibiotic Use in Adult Patients
Adult pharyngitis is rarely attributable to group A streptococci. Utilization of a rapid streptococcal antigen test (RADT) may improve appropriate prescribing for bacterial pharyngitis. Clinic 1 performed RADTs with subsequent Group A DNA probe test (GADNA) from November 2014-March 2015 and November...
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| Veröffentlicht in: | Diagnostic microbiology and infectious disease 2018-08, Vol.91 (4), p.339-344 |
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| creator | Dodd, Monique Adolphe, Allen Parada, Alisha Brett, Meghan Culbreath, Karissa Mercier, Renée-Claude |
| description | Adult pharyngitis is rarely attributable to group A streptococci. Utilization of a rapid streptococcal antigen test (RADT) may improve appropriate prescribing for bacterial pharyngitis.
Clinic 1 performed RADTs with subsequent Group A DNA probe test (GADNA) from November 2014-March 2015 and November 2015-March 2016 while Clinic 2 was the control clinic, then implemented the RADT with a GADNA from November 2015-March 2016. All GADNA results were obtained for each clinic from October 2013-March 2016.
At Clinic 1, 22.2% versus 8.5% of patients received inappropriately prescribed antibiotics for a GADNA or RADT result, respectively (p=0.048). For Clinic 2, 51.1% compared to 21.4% of patients were inappropriately prescribed antibiotic for a GADNA or RADT result, respectively (p=0.038). Overall, the total GADNA without RADT testing or RADTs with subsequent GADNA testing, 41.6% versus 11% of patients were inappropriately prescribed antibiotics, respectively (p= |
| doi_str_mv | 10.1016/j.diagmicrobio.2018.03.018 |
| format | Article |
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Clinic 1 performed RADTs with subsequent Group A DNA probe test (GADNA) from November 2014-March 2015 and November 2015-March 2016 while Clinic 2 was the control clinic, then implemented the RADT with a GADNA from November 2015-March 2016. All GADNA results were obtained for each clinic from October 2013-March 2016.
At Clinic 1, 22.2% versus 8.5% of patients received inappropriately prescribed antibiotics for a GADNA or RADT result, respectively (p=0.048). For Clinic 2, 51.1% compared to 21.4% of patients were inappropriately prescribed antibiotic for a GADNA or RADT result, respectively (p=0.038). Overall, the total GADNA without RADT testing or RADTs with subsequent GADNA testing, 41.6% versus 11% of patients were inappropriately prescribed antibiotics, respectively (p=<0.0001).
Utilizing the RADT prevented unnecessary prescribing of antibiotics in adults.
•Rapid streptococcal antigen test improves outpatient prescribing of antibiotics•Highly sensitive rapid step tests foster early identification and treatment•Clinical symptoms with rapid test results rarely conflict with the standard of care</description><identifier>ISSN: 0732-8893</identifier><identifier>EISSN: 1879-0070</identifier><identifier>DOI: 10.1016/j.diagmicrobio.2018.03.018</identifier><identifier>PMID: 29731388</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Anti-Bacterial Agents - standards ; Anti-Bacterial Agents - therapeutic use ; antibiotics ; Antigens, Bacterial - immunology ; antimicrobial stewardship ; Diagnostic Tests, Routine - methods ; Diagnostic Tests, Routine - standards ; DNA probe ; Early Diagnosis ; Female ; group A streptococcal ; Humans ; Immunologic Tests - methods ; Inappropriate Prescribing - prevention & control ; Inappropriate Prescribing - statistics & numerical data ; Male ; Middle Aged ; Molecular Diagnostic Techniques ; pharyngitis ; Pharyngitis - diagnosis ; Pharyngitis - drug therapy ; Pharyngitis - microbiology ; RADT ; Sensitivity and Specificity ; Streptococcal Infections - diagnosis ; Streptococcal Infections - drug therapy ; Streptococcal Infections - microbiology ; Streptococcus pyogenes - immunology ; Streptococcus pyogenes - isolation & purification</subject><ispartof>Diagnostic microbiology and infectious disease, 2018-08, Vol.91 (4), p.339-344</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-463bb1f9e6fd2aa1d2107cfd1579af7faa94b2ff9f01061cce579bddfbee7eca3</citedby><cites>FETCH-LOGICAL-c446t-463bb1f9e6fd2aa1d2107cfd1579af7faa94b2ff9f01061cce579bddfbee7eca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.diagmicrobio.2018.03.018$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29731388$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dodd, Monique</creatorcontrib><creatorcontrib>Adolphe, Allen</creatorcontrib><creatorcontrib>Parada, Alisha</creatorcontrib><creatorcontrib>Brett, Meghan</creatorcontrib><creatorcontrib>Culbreath, Karissa</creatorcontrib><creatorcontrib>Mercier, Renée-Claude</creatorcontrib><title>Clinical Impact of a Rapid Streptococcal Antigen Test on Antibiotic Use in Adult Patients</title><title>Diagnostic microbiology and infectious disease</title><addtitle>Diagn Microbiol Infect Dis</addtitle><description>Adult pharyngitis is rarely attributable to group A streptococci. Utilization of a rapid streptococcal antigen test (RADT) may improve appropriate prescribing for bacterial pharyngitis.
Clinic 1 performed RADTs with subsequent Group A DNA probe test (GADNA) from November 2014-March 2015 and November 2015-March 2016 while Clinic 2 was the control clinic, then implemented the RADT with a GADNA from November 2015-March 2016. All GADNA results were obtained for each clinic from October 2013-March 2016.
At Clinic 1, 22.2% versus 8.5% of patients received inappropriately prescribed antibiotics for a GADNA or RADT result, respectively (p=0.048). For Clinic 2, 51.1% compared to 21.4% of patients were inappropriately prescribed antibiotic for a GADNA or RADT result, respectively (p=0.038). Overall, the total GADNA without RADT testing or RADTs with subsequent GADNA testing, 41.6% versus 11% of patients were inappropriately prescribed antibiotics, respectively (p=<0.0001).
Utilizing the RADT prevented unnecessary prescribing of antibiotics in adults.
•Rapid streptococcal antigen test improves outpatient prescribing of antibiotics•Highly sensitive rapid step tests foster early identification and treatment•Clinical symptoms with rapid test results rarely conflict with the standard of care</description><subject>Adult</subject><subject>Anti-Bacterial Agents - standards</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>antibiotics</subject><subject>Antigens, Bacterial - immunology</subject><subject>antimicrobial stewardship</subject><subject>Diagnostic Tests, Routine - methods</subject><subject>Diagnostic Tests, Routine - standards</subject><subject>DNA probe</subject><subject>Early Diagnosis</subject><subject>Female</subject><subject>group A streptococcal</subject><subject>Humans</subject><subject>Immunologic Tests - methods</subject><subject>Inappropriate Prescribing - prevention & control</subject><subject>Inappropriate Prescribing - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Molecular Diagnostic Techniques</subject><subject>pharyngitis</subject><subject>Pharyngitis - diagnosis</subject><subject>Pharyngitis - drug therapy</subject><subject>Pharyngitis - microbiology</subject><subject>RADT</subject><subject>Sensitivity and Specificity</subject><subject>Streptococcal Infections - diagnosis</subject><subject>Streptococcal Infections - drug therapy</subject><subject>Streptococcal Infections - microbiology</subject><subject>Streptococcus pyogenes - immunology</subject><subject>Streptococcus pyogenes - isolation & purification</subject><issn>0732-8893</issn><issn>1879-0070</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtOHDEQRS0UFAaSX0AWq2y6KdtNu80ODU8JCZTAIivLbZeRR_2i7UHi7-NhAGXJ6qpct3yrDiFHDEoGrD5elS6Ypz7YeWzDWHJgTQmizLJDFqyRqgCQ8I0sQApeNI0Se2Q_xhUA46qC72SPKymYaJoF-bvswhCs6ehNPxmb6Oipob_NFBz9k2ac0mhHu-mfDSk84UAfMGbX8Fbn-BQsfYxIQ35x6y7Re5MCDin-ILvedBF_vusBeby8eFheF7d3VzfLs9vCVlWdiqoWbcu8wto7bgxznIG03rETqYyX3hhVtdx75YFBzazF3Gid8y2iRGvEAfm1_Xeax-d1Xk73IVrsOjPguI6agziRUCuusvV0a83kYpzR62kOvZlfNQO9QatX-n-0eoNWg9BZ8vDhe8667dF9jn6wzIbzrQHztS8BZx1tJmHRhRlt0m4MX8n5B4H_krg</recordid><startdate>201808</startdate><enddate>201808</enddate><creator>Dodd, Monique</creator><creator>Adolphe, Allen</creator><creator>Parada, Alisha</creator><creator>Brett, Meghan</creator><creator>Culbreath, Karissa</creator><creator>Mercier, Renée-Claude</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201808</creationdate><title>Clinical Impact of a Rapid Streptococcal Antigen Test on Antibiotic Use in Adult Patients</title><author>Dodd, Monique ; Adolphe, Allen ; Parada, Alisha ; Brett, Meghan ; Culbreath, Karissa ; Mercier, Renée-Claude</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-463bb1f9e6fd2aa1d2107cfd1579af7faa94b2ff9f01061cce579bddfbee7eca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - standards</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>antibiotics</topic><topic>Antigens, Bacterial - immunology</topic><topic>antimicrobial stewardship</topic><topic>Diagnostic Tests, Routine - methods</topic><topic>Diagnostic Tests, Routine - standards</topic><topic>DNA probe</topic><topic>Early Diagnosis</topic><topic>Female</topic><topic>group A streptococcal</topic><topic>Humans</topic><topic>Immunologic Tests - methods</topic><topic>Inappropriate Prescribing - prevention & control</topic><topic>Inappropriate Prescribing - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Molecular Diagnostic Techniques</topic><topic>pharyngitis</topic><topic>Pharyngitis - diagnosis</topic><topic>Pharyngitis - drug therapy</topic><topic>Pharyngitis - microbiology</topic><topic>RADT</topic><topic>Sensitivity and Specificity</topic><topic>Streptococcal Infections - diagnosis</topic><topic>Streptococcal Infections - drug therapy</topic><topic>Streptococcal Infections - microbiology</topic><topic>Streptococcus pyogenes - immunology</topic><topic>Streptococcus pyogenes - isolation & purification</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dodd, Monique</creatorcontrib><creatorcontrib>Adolphe, Allen</creatorcontrib><creatorcontrib>Parada, Alisha</creatorcontrib><creatorcontrib>Brett, Meghan</creatorcontrib><creatorcontrib>Culbreath, Karissa</creatorcontrib><creatorcontrib>Mercier, Renée-Claude</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diagnostic microbiology and infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dodd, Monique</au><au>Adolphe, Allen</au><au>Parada, Alisha</au><au>Brett, Meghan</au><au>Culbreath, Karissa</au><au>Mercier, Renée-Claude</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Impact of a Rapid Streptococcal Antigen Test on Antibiotic Use in Adult Patients</atitle><jtitle>Diagnostic microbiology and infectious disease</jtitle><addtitle>Diagn Microbiol Infect Dis</addtitle><date>2018-08</date><risdate>2018</risdate><volume>91</volume><issue>4</issue><spage>339</spage><epage>344</epage><pages>339-344</pages><issn>0732-8893</issn><eissn>1879-0070</eissn><abstract>Adult pharyngitis is rarely attributable to group A streptococci. Utilization of a rapid streptococcal antigen test (RADT) may improve appropriate prescribing for bacterial pharyngitis.
Clinic 1 performed RADTs with subsequent Group A DNA probe test (GADNA) from November 2014-March 2015 and November 2015-March 2016 while Clinic 2 was the control clinic, then implemented the RADT with a GADNA from November 2015-March 2016. All GADNA results were obtained for each clinic from October 2013-March 2016.
At Clinic 1, 22.2% versus 8.5% of patients received inappropriately prescribed antibiotics for a GADNA or RADT result, respectively (p=0.048). For Clinic 2, 51.1% compared to 21.4% of patients were inappropriately prescribed antibiotic for a GADNA or RADT result, respectively (p=0.038). Overall, the total GADNA without RADT testing or RADTs with subsequent GADNA testing, 41.6% versus 11% of patients were inappropriately prescribed antibiotics, respectively (p=<0.0001).
Utilizing the RADT prevented unnecessary prescribing of antibiotics in adults.
•Rapid streptococcal antigen test improves outpatient prescribing of antibiotics•Highly sensitive rapid step tests foster early identification and treatment•Clinical symptoms with rapid test results rarely conflict with the standard of care</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29731388</pmid><doi>10.1016/j.diagmicrobio.2018.03.018</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Anti-Bacterial Agents - standards Anti-Bacterial Agents - therapeutic use antibiotics Antigens, Bacterial - immunology antimicrobial stewardship Diagnostic Tests, Routine - methods Diagnostic Tests, Routine - standards DNA probe Early Diagnosis Female group A streptococcal Humans Immunologic Tests - methods Inappropriate Prescribing - prevention & control Inappropriate Prescribing - statistics & numerical data Male Middle Aged Molecular Diagnostic Techniques pharyngitis Pharyngitis - diagnosis Pharyngitis - drug therapy Pharyngitis - microbiology RADT Sensitivity and Specificity Streptococcal Infections - diagnosis Streptococcal Infections - drug therapy Streptococcal Infections - microbiology Streptococcus pyogenes - immunology Streptococcus pyogenes - isolation & purification |
| title | Clinical Impact of a Rapid Streptococcal Antigen Test on Antibiotic Use in Adult Patients |
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