Rapid strip tests as a decision-making tool about antibiotic treatment in children – A prospective study

Background
Although three quarters of seasonal infections of the upper respiratory tract in children are of viral etiology, majority of the patients are unnecessarily prescribed antibiotics despite the availability of rapid diagnostic tests differentiating between infections. This study aimed to assess the relation between the use of rapid strip tests which detect the antigens of group A beta-hemolytic streptococcus (Streptococcus pyogenes) in pharyngitis and/or tonsillitis and the frequency of antibiotic use in children and adolescents aged 2–15 years.

Methods
The data were collected from 1307 children from the region of southeast Poland who then were divided into a sample group (n = 581) in which patients received a rapid strip test before treatment plan was established by the physician, and into a control group (n = 726) in which the decision whether to administer an antibiotic was made without the use of the rapid test. Based on statistical decision¬making method, a pharmacoeconomic analysis of costs and effectiveness of strip tests was performed.

Results
The use of the rapid strip test resulted in identifying the streptococcal infection in 31.7% of children and allowed to lessen the antibiotic use by 5.1%. The number of follow-up visits decreased (86.4% vs. 96.0%) and the anticipated cost of treatment decreased by 17%.

Conclusions
Rapid diagnostic tests used by the family physicians in initial diagnostics of seasonal upper respiratory tract infections in children allowed to differentiate between the type of infection as well as reduce the number of follow-up visits. Also, the antibiotic spending reimbursed by the insurer decreased by 17%.