Physicians Office Resource Volume 12 Issue 8 | Page 4

8 GROUP A STREPTOCOCCAL PHARYNGITIS TESTING GUIDELINES AND PROCEDURAL LIMITATIONS By Irwin Z. Rothenberg, MBA, MS, CLS(ASCP), Technical Writer / Quality Advisor, COLA Resources, Inc. Strep tests are used to determine if a person with a sore throat (pharyngitis) has strep throat, an infection of the throat and tonsils caused by the bacteria Streptococcus pyogenes, also called Group A Streptococcus (GAS), or if the sore throat is caused by a virus. The majority of sore throats (70%-85%) are actually viral in nature, and will resolve without treatment within a few days. However, it is important to determine when sore throats are caused by GAS, since this is the most common bacterial cause of acute pharyngitis, responsible for 5%–15% of sore throat visits in adults and 20%–30% in children. It is most common in children ages 5 to 15 years old (over 50 % of the cases occur within this age bracket); it is very contagious; and needs to be identified as soon as possible, and treated with antibiotics. Accurate diagnosis of streptococcal pharyngitis followed by appropriate antimicrobial therapy is important for the prevention of acute rheumatic fever; for the prevention of suppurative complications (e.g. peritonsillar abscess, cervical lymphadenitis, mastoiditis, and, possibly, other invasive 4 infections); to improve clinical symptoms and signs; for the rapid decrease in contagiousness; for the reduction in transmission of GAS to family members, classmates, and other close contacts of the patient; to allow for the rapid resumption of usual activities; and for the minimization of potential adverse effects of inappropriate antimicrobial therapy. Fortunately, most streptococcal infections are now routinely diagnosed and treated through rapid strep testing, these complications are rare in the United States, but they do still occur. Establishing the Diagnosis of GAS Pharyngitis 1. Swabbing the throat and testing for GAS pharyngitis by rapid strep test and/or throat culture should be performed because clinical features alone do not reliably discriminate between GAS and viral pharyngitis except when overt viral features like runny nose, cough, oral ulceration, and/or hoarseness are present. In children and adolescents, negative rapid strep tests should be backed up by a throat culture; however, www.PhysiciansOfficeResource.com