ArticleBMC pediatrics2019
Diagnosis and antibiotic treatment of group a streptococcal pharyngitis in children in a primary care setting: impact of point-of-care polymerase chain reaction.
Article in BMC pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Efficacy and safety of rapid tests to guide antibiotic prescriptions for sore throat.The Cochrane database of systematic reviews · 2020Pooled it
- Multi-center investigation on the influence of clinical characteristics and molecular group A streptococci diagnostics on the management of tonsillopharyngitis in pediatric practices in Berlin-BASE study.European journal of pediatrics · 2026Trial
- An emm-type specific qPCR to track bacterial load during experimental human Streptococcus pyogenes pharyngitis.BMC infectious diseases · 2021Trial
- Evaluation of a fully automated "sample-to-result" PCR-based diagnostic test for detecting A/C/G Streptococci from throat swab specimens.Microbiology spectrum · 2026Article
- Development of the CRISPR-Cas12a-Based Biosensing System for Rapid, Ultrasensitive, and Highly Specific Detection ofACS omega · 2025Article
- Review: Current Laboratory and Point-of-Care Pharyngitis Diagnostic Testing and Knowledge Gaps.The Journal of infectious diseases · 2024Review
- Role of H.pylori in Chronic Sore Throat by Using H.pylori Line.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2024Article
- Group A β-hemolytic Streptococcal Pharyngitis: An Updated Review.Current pediatric reviews · 2024Review
- Rapid diagnostics to enhance therapy selection for the treatment of bacterial infections.Current pharmacology reports · 2023Article
- Point-of-Care and Rapid Tests for the Etiological Diagnosis of Respiratory Tract Infections in Children: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2022Review
- Antimicrobial Stewardship Strategies Including Point-of-Care Testing (POCT) for Pediatric Patients with Upper-Respiratory-Tract Infections in Primary Care: A Systematic Review of Economic Evaluations.Antibiotics (Basel, Switzerland) · 2022Review
- The Impact of Point-of-Care Polymerase Chain Reaction Testing on Prescribing Practices in Primary Care for Management of Strep A: A Retrospective Before-After Study.Open forum infectious diseases · 2022Article
- Simple Electric Device to Isolate Nucleic Acids from Whole Blood Optimized for Point of Care Testing of Brain Damage.Current neurovascular research · 2022Article
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- Article
- Paediatrics: how to manage pharyngitis in an era of increasing antimicrobial resistance.Drugs in context · 2021Review
- Point-of-Care Testing for Pharyngitis in the Pharmacy.Antibiotics (Basel, Switzerland) · 2020Article
- Toward automated severe pharyngitis detection with smartphone camera using deep learning networks.Computers in biology and medicine · 2020Article
- Nasopharyngeal Isolates from a Cohort of Medical Students with or without Pharyngitis.Sultan Qaboos University medical journal · 2020Article
- Group A Streptococcus Testing in Pediatrics: the Move to Point-of-Care Molecular Testing.Journal of clinical microbiology · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo compare the sensitivity and specificity of the recommended 2-step rapid antigen detection test (RADT) with confirmatory culture vs the point-of-care (POC) polymerase chain reaction (PCR) Roche cobas® Liat® Strep A test for detection of group A Streptococcus (GAS) in pediatric patients with pharyngitis, and to investigate the impact of these tests on antibiotic use in a large pediatric clinic.
methodsThis prospective, open-label study was conducted at a single site during fall/winter 2016-2017. A total of 275 patients aged 3 to 18 years with symptoms of pharyngitis had a throat-swab specimen analyzed using RADT, POC PCR, and culture. The sensitivity, specificity, and percentage agreement (95% CI) between assays and a laboratory-based nucleic acid amplification test were calculated. DNA sequencing was used to adjudicate discrepancies. The RADT or POC PCR result was provided to clinicians on alternating weeks to compare the impact on antibiotic use.
resultsA total of 255 samples were evaluated; 110 (43.1%) were GAS positive. Sensitivities (95% CI) for POC PCR, RADT, and culture were 95.5% (89.7-98.5%), 85.5% (77.5-1.5%), and 71.8% (62.4-80.0%), respectively. Specificities (95% CI) for POC PCR, RADT, and culture were 99.3% (96.2-99.98%), 93.7% (88.5-97.1%), and 100% (97.5-100%), respectively. Compared with RADT, POC PCR resulted in significantly greater appropriate antibiotic use (97.1% vs 87.5%; P = .0065).
conclusionUnder real-world conditions, RADT results were less specific and culture results were less sensitive than found in established literature and led to increased rates of inappropriate antibiotic use. POC PCR had high sensitivity and specificity and rapid turnaround times, and led to more appropriate antibiotic use.
trial registrationID number ISRCTN84562679 . Registered October 162,018, retrospectively registered.
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