PURPOSE: This study evaluated the effect of Rapid Streptococcal Screening Test (RSST) results on the use of antibiotics for patients with sore throat in the ER setting and the effect of education about Centor criteria for primary physicians on the use of antibiotics. METHODS: Between June 2008 and January 2009, we recruited 786 patients with sore throat who visited our emergency center. Patients were classified into 2 groups according to the RSST. Centor scores and antibiotic usage were assessed. Primary physicians were educated about Centor scoring and RSST. We analyzed the use of antibiotics to evaluate the effect of education on Centor scoring and RSST. RESULTS: RSST results significantly correlated with antibiotic usage for the RSST done on a group of patients with sore throat (p<0.001). Education of primary physicians regarding Centor scoring reduced the use of antibiotics (p<0.001) for the low risk group of patients (Centor scores<3). The use of antibiotics for the high risk group (Centor scores> or =3) was not significantly reduced (p=0.6394) after education regarding Centor criteria. CONCLUSION: The use of an RSS test and education of primary physicians will reduce the unnecessary use of antibiotics by patients and will result in appropriate use of antibiotics for patients who need antibiotics.
Anti-Bacterial Agents ; Emergencies ; Humans ; Mass Screening ; Pharyngitis ; Streptococcal Infections

PURPOSE: This paper compares a RSS (Rapid Streptococcal Screening) detection test with a throat culture. The RSS detection kit is an easier and faster way to identify the infection of Group A beta-hemolytic streptococcus (GABHS), the most common causal agent of acute bacterial pharyngitis. We also examine the clinical symptoms that are associated with bacterial pharyngitis. METHODS: A throat culture and a RSS detection test were performed simultaneously to all 239 patients who were suspected of having acute pharyngitis, and visited the emergency department between September 1st, 2002, and June 30th, 2003. Then the values of the RSS detection test were analyzed comparatively on a chi square test. The correlation between Centor criteria clinical features and bacterial pharyngitis was examined through a logic regression test. RESULTS: Comparative analysis of the results of a throat culture and RSS detection test showed a test sensitivity of 83.6%, specificity was 97.2%, and the kappa coefficient was 0.83 (95% C.I: 0.75~0.91). This suggests that the RSS detection test is valuable statistically. CONCLUSION: The RSS detection test is more accurate than the diagnosis of bacterial pharyngitis based on clinical features. Assuming that all patients with acute pharyngitis take antibiotics, an RSS detection test reduce of unnecessary antibiotics use.
Anti-Bacterial Agents ; Emergencies ; Humans ; Logic ; Pharyngitis ; Pharynx ; Sensitivity and Specificity ; Streptococcal Infections ; Streptococcus