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Negative antigen test misses <5% of strep pharyngitis
PRACTICE RECOMMENDATIONS

For patients with an average risk of having streptococcal pharyngitis, a number of testing strategies can rule out infection, including a single negative rapid strep antigen test, which has a negative predictive value of more than 95%. In patients at higher risk of having strep, based on clinical criteria, all the test strategies being studied are more likely to be falsely negative.

While it is reasonable to rely on a variety of strategies to exclude strep throat in average-risk patients, high-risk patients with a negative rapid antigen test should have an additional rapid strep test or a throat culture to exclude strep with a certainty of greater than 95%.

 
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Practice Recommendations from Key Studies

Gieseker KE, Roe MH, MacKenzie T, Todd JK. Evaluating the American Academy of Pediatric diagnostic standard for Streptococcus pyogenes pharyngitis: Backup culture versus repeat rapid antigen testing. Pediatrics 2003; 111:e666–e670.

John Gazewood, MD, MSPH
Department of Family Medicine, University of Virginia Health System, Charlottesville. [email protected].

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The Journal of Family Practice - 52(10)
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747-769
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Practice Recommendations from Key Studies

Gieseker KE, Roe MH, MacKenzie T, Todd JK. Evaluating the American Academy of Pediatric diagnostic standard for Streptococcus pyogenes pharyngitis: Backup culture versus repeat rapid antigen testing. Pediatrics 2003; 111:e666–e670.

John Gazewood, MD, MSPH
Department of Family Medicine, University of Virginia Health System, Charlottesville. [email protected].

Author and Disclosure Information

Practice Recommendations from Key Studies

Gieseker KE, Roe MH, MacKenzie T, Todd JK. Evaluating the American Academy of Pediatric diagnostic standard for Streptococcus pyogenes pharyngitis: Backup culture versus repeat rapid antigen testing. Pediatrics 2003; 111:e666–e670.

John Gazewood, MD, MSPH
Department of Family Medicine, University of Virginia Health System, Charlottesville. [email protected].

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PRACTICE RECOMMENDATIONS

For patients with an average risk of having streptococcal pharyngitis, a number of testing strategies can rule out infection, including a single negative rapid strep antigen test, which has a negative predictive value of more than 95%. In patients at higher risk of having strep, based on clinical criteria, all the test strategies being studied are more likely to be falsely negative.

While it is reasonable to rely on a variety of strategies to exclude strep throat in average-risk patients, high-risk patients with a negative rapid antigen test should have an additional rapid strep test or a throat culture to exclude strep with a certainty of greater than 95%.

 
PRACTICE RECOMMENDATIONS

For patients with an average risk of having streptococcal pharyngitis, a number of testing strategies can rule out infection, including a single negative rapid strep antigen test, which has a negative predictive value of more than 95%. In patients at higher risk of having strep, based on clinical criteria, all the test strategies being studied are more likely to be falsely negative.

While it is reasonable to rely on a variety of strategies to exclude strep throat in average-risk patients, high-risk patients with a negative rapid antigen test should have an additional rapid strep test or a throat culture to exclude strep with a certainty of greater than 95%.

 
Issue
The Journal of Family Practice - 52(10)
Issue
The Journal of Family Practice - 52(10)
Page Number
747-769
Page Number
747-769
Publications
Publications
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Negative antigen test misses <5% of strep pharyngitis
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Negative antigen test misses <5% of strep pharyngitis
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