{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T11:23:26Z","timestamp":1773141806441,"version":"3.50.1"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Sore throat is a common presentation to the children's emergency department (ED), and many patients are likely prescribed antibiotics unnecessarily. We aimed to reduce antibiotic prescribing for sore throat in our UK ED through use of an established scoring system combined with a rapid diagnostic test (RDT) to detect group A streptococcal (GAS) pharyngitis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>AB single-subject and diagnostic accuracy studies were used to measure both antibiotic prescribing rates over time and the performance of the McIsaac clinical score combined with RDT to screen for and treat GAS pharyngitis. All children between the age of 6 months and 16 years with symptoms of sore throat were eligible for inclusion. The study adhered to SQUIRE guidelines.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>During 2014 and 2016, antibiotic prescribing rates for 210 children at baseline (median age, 3 years) and 395 children during the intervention (median age, 2 years) were assessed. The baseline prescribing rate was 79%, whereas rates after intervention were 24% and 27%, respectively. The RDT had an acceptable false-negative rate of 7.9%, poor sensitivity of 64.3%, and a negative predictive value of 92.1% when compared with conventional throat culture. A McIsaac score of 3 or more had good sensitivity (92.11%) but very low specificity (12.62%) for predicting GAS infection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Despite poor RDT sensitivity and the McIsaac score's poor specificity in children, their use in combination decreased antibiotic prescribing rates in a children's ED setting.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000001560","type":"journal-article","created":{"date-parts":[[2018,7,25]],"date-time":"2018-07-25T04:47:05Z","timestamp":1532494025000},"page":"e249-e251","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["A Pragmatic Study to Evaluate the Use of a Rapid Diagnostic Test to Detect Group A Streptococcal Pharyngitis in Children With the Aim of Reducing Antibiotic Use in a UK Emergency Department"],"prefix":"10.1097","volume":"37","author":[{"given":"Chris","family":"Bird","sequence":"first","affiliation":[{"name":"Emergency Department, John Radcliffe Hospital, Oxford"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma","family":"Winzor","sequence":"additional","affiliation":[{"name":"Public Health England Midlands and East Region"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Lemon","sequence":"additional","affiliation":[{"name":"Emergency Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alasdair","family":"Moffat","sequence":"additional","affiliation":[{"name":"Emergency Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Newton","sequence":"additional","affiliation":[{"name":"Emergency Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim","family":"Gray","sequence":"additional","affiliation":[{"name":"Microbiology Department, Birmingham Children's Hospital, Birmingham, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2018,7,25]]},"reference":[{"issue":"suppl 9","key":"bib1-20250504","first-page":"3","article-title":"Rapid streptococcal testing for sore throat and antibiotic resistance","volume":"12","year":"2006","journal-title":"Clin Microbiol Infect"},{"key":"bib2-20250504","article-title":"Management of sore throat and indications for tonsillectomy","year":"2010","journal-title":"Edinburgh"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1136\/emj.2004.022970","article-title":"Streptococcus A in paediatric accident and emergency: are rapid streptococcal tests and clinical examination of any help?","volume":"23","year":"2006","journal-title":"Emerg Med J"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1097\/00006565-199812000-00004","article-title":"Evaluation of a new rapid antigen detection kit for group A beta-hemolytic streptococci","volume":"14","year":"1998","journal-title":"Pediatr Emerg Care"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1097\/PEC.0b013e31823aff44","article-title":"Should a near-patient test be part of the management of pharyngitis in the pediatric emergency department?","volume":"27","year":"2011","journal-title":"Pediatr Emerg Care"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1136\/jclinpath-2016-203808","article-title":"Antibiotics for tonsillitis: should the emergency department emulate general practice?","volume":"69","year":"2016","journal-title":"J Clin Pathol"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1093\/cid\/ciu400","article-title":"Reflexive culture in adolescents and adults with group A streptococcal pharyngitis","volume":"59","year":"2014","journal-title":"Clin Infect Dis"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"e111727","DOI":"10.1371\/journal.pone.0111727","article-title":"Rapid antigen group A streptococcus test to diagnose pharyngitis: a systematic review and meta-analysis","volume":"9","year":"2014","journal-title":"PLoS One"},{"issue":"suppl 1","key":"bib9-20250504","first-page":"1","article-title":"Guideline for the management of acute sore throat","volume":"18","year":"2012","journal-title":"Clin Microbiol Infect"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"e39085","DOI":"10.1371\/journal.pone.0039085","article-title":"Spectrum and inoculum size effect of a rapid antigen detection test for group A streptococcus in children with pharyngitis","volume":"7","year":"2012","journal-title":"PLoS One"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"3293","DOI":"10.1093\/jac\/dkw264","article-title":"A feasibility service evaluation of screening and treatment of group A streptococcal pharyngitis in community pharmacies","volume":"71","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1136\/bmjqs-2015-004480","article-title":"Explanation and elaboration of the SQUIRE (Standards for Quality Improvement Reporting Excellence) Guidelines, V.2.0: examples of SQUIRE elements in the healthcare improvement literature","volume":"25","year":"2016","journal-title":"BMJ Qual Saf"},{"key":"bib14-20250504","first-page":"811","article-title":"The validity of a sore throat score in family practice","volume":"163","year":"2000","journal-title":"CMAJ"},{"key":"bib16-20250504","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1136\/pgmj.2004.031005","article-title":"Use of the single subject design for practice based primary care research","volume":"81","year":"2005","journal-title":"Postgrad Med J"},{"key":"bib17-20250504","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.pedneo.2011.11.010","article-title":"Evaluation of a streptococcal pharyngitis score in southern Taiwan","volume":"53","year":"2012","journal-title":"Pediatr Neonatol"},{"key":"bib18-20250504","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/1742-6723.12567","article-title":"Point of care testing for group A streptococci in patients presenting with pharyngitis will improve appropriate antibiotic prescription","volume":"28","year":"2016","journal-title":"Emerg Med Australas"},{"key":"bib19-20250504","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1093\/tropej\/fmw014","article-title":"The effect of rapid antigen detection test on antibiotic prescription decision of clinicians and reducing antibiotic costs in children with acute pharyngitis","volume":"62","year":"2016","journal-title":"J Trop Pediatr"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001560","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:04:51Z","timestamp":1746381891000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,25]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001560","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2018,7,25]]}}}