CoChat
Sign Up
Cited by 102Streptococcal Infections and TreatmentsAntibiotic Use and ResistanceOtolaryngology and Infectious Diseases

Diagnostic Methods, Clinical Guidelines, and Antibiotic Treatment for Group A Streptococcal Pharyngitis: A Narrative Review

Open access
Mustafa, Zahid, Ghaffari, Masoumeh·2020·Frontiers in Cellular and Infection Microbiology
DOI 10.3389/fcimb.2020.563627PMC PMC7593338
Open this paper in CoChat — free accountOpen PDF

Abstract

-hemolytic streptococcus (GABHS), commonly known as strep throat. 5-15% of adults and 15-35% of children in the United States with pharyngitis have a GABHS infection. The symptoms of GABHS overlap with non-GABHS and viral causes of acute pharyngitis, complicating the problem of diagnosis. A careful physical examination and patient history is the starting point for diagnosing GABHS. After a physical examination and patient history is completed, five types of diagnostic methods can be used to ascertain the presence of a GABHS infection: clinical scoring systems, rapid antigen detection tests, throat culture, nucleic acid amplification tests, and machine learning and artificial intelligence. Clinical guidelines developed by professional associations can help medical professionals choose among available techniques to diagnose strep throat. However, guidelines for diagnosing GABHS created by the American and European professional associations vary significantly, and there is substantial evidence that most physicians do not follow any published guidelines. Treatment for GABHS using analgesics, antipyretics, and antibiotics seeks to provide symptom relief, shorten the duration of illness, prevent nonsuppurative and suppurative complications, and decrease the risk of contagion, while minimizing the unnecessary use of antibiotics. There is broad agreement that antibiotics with narrow spectrums of activity are appropriate for treating strep throat. But whether and when patients should be treated with antibiotics for GABHS remains a controversial question. There is no clearly superior management strategy for strep throat, as significant controversy exists regarding the best methods to diagnose GABHS and under what conditions antibiotics should be prescribed.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3389/fcimb.2020.563627

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Diagnostic guidelines provide a standardized and evidence-based framework that enhances accuracy, consistency, and quality in diagnosis, supporting more efficient and reliable care and improved patient outcomes.

    “Diagnostic guidelines provide a standardized and evidence-based framework that enhances accuracy, consistency, and quality in diagnosis, ultimately supporting more efficient and reliable care and improved patient outcomes [139,140].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [139]

    In “Clinical Guidelines for GABHS” (page unavailable), the review says a standardized guideline-development method should harmonize approaches, reduce confusion, and lead to better health outcomes. It also calls for greater guideline use to make GABHS diagnoses more consistent and accurate. The claim extends these proposed benefits to diagnostic guidelines generally and adds more efficient and reliable care, which the passages do not establish. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

No references could be resolved yet.

Research works printed but not linked: 95

  1. Aalbers J. O’Brien K. K. Chan W. S. Falk G. A. Teljeur C. Dimitrov B. D. (2011). Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score. BMC Med. 9, 67. 10.1186/1741-7015-9-67 21631919 PMC3127779 · DOI
  2. Adler L. Parizade M. Koren G. Yehoshua I. (2020). Oral cavity swabbing for diagnosis of group a Streptococcus: a prospective study. BMC Fam. Pract. 21 (1), 57. 10.1186/s12875-020-01129-6 32216750 PMC7098072 · DOI
  3. Ahmed MH H. M. Eida M. M. Metwally L. A. (2015). Evaluation of Appropriateness of Antibiotic Use and Validation of the Mclsaac-Modified Centor Score for Group A Beta Hemolytic Streptococcal Acute Pharyngitis in Suez Canal Area. Suez Canal Univ. Med. J. 18 (2), 117– 124. 10.21608/SCUMJ.2015.45612 · DOI
  4. Altamimi S. Khalil A. Khalaiwi K. A. Milner R. A. Pusic M. V. Al Othman M. A. (2012). Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children. Cochrane Database Syst. Rev. (8), CD004872. 10.1002/14651858.CD004872.pub3 22895944 PMC11984625 · DOI
  5. Anderson N. W. Buchan B. W. Mayne D. Mortensen J. E. Mackey T. L. Ledeboer N. A. (2013). Multicenter clinical evaluation of the illumigene group A Streptococcus DNA amplification assay for detection of group A Streptococcus from pharyngeal swabs. J. Clin. Microbiol. 51 (5), 1474– 1477. 10.1128/JCM.00176-13 23447639 PMC3647941 · DOI
  6. Askarian B. Yoo S. C. Chong J. W. (2019). Novel Image Processing Method for Detecting Strep Throat (Streptococcal Pharyngitis) Using Smartphone. Sensors (Basel) 19 (15), 3307– 3324. 10.3390/s19153307 PMC6695774 31357633 · DOI
  7. Azrad M. Danilov E. Goshen S. Nitzan O. Peretz A. (2019). Detection of group a Streptococcus in pharyngitis by two rapid tests: comparison of the BD Veritor and the QuikRead go(R) Strep A. Eur. J. Clin. Microbiol. Infect. Dis. 38 (6), 1179– 1185. 10.1007/s10096-019-03527-w 30852698 · DOI
  8. Bisno A. L. (2003). Diagnosing strep throat in the adult patient: do clinical criteria really suffice? Ann. Intern. Med. 139 (2), 150– 151. 10.7326/0003-4819-139-2-200307150-00015 12859165 · DOI
  9. Breese B. B. (1977). A simple scorecard for the tentative diagnosis of streptococcal pharyngitis. Am. J. Dis. Child 131 (5), 514– 517. 10.1001/archpedi.1977.02120180028003 855837 · DOI
  10. Butler C. C. Francis N. (2008). Commentary: Controversies in NICE guidance on antibiotic prescribing for self limiting respiratory tract infections in primary care. BMJ 337, a656. 10.1136/bmj.a656 18650240 · DOI
  11. Carapetis J. R. Steer A. C. Mulholland E. K. Weber M. (2005). The global burden of group A streptococcal diseases. Lancet Infect. Dis. 5 (11), 685– 694. 10.1016/S1473-3099(05)70267-X 16253886 · DOI
  12. Centor R. M. Witherspoon J. M. Dalton H. P. Brody C. E. Link K. (1981). The diagnosis of strep throat in adults in the emergency room. Med. Decis. Making 1 (3), 239– 246. 10.1177/0272989X8100100304 6763125 · DOI
  13. Centor R. M. (2012). Adolescent and adult pharyngitis: more than “strep throat”: comment on “Large-scale validation of the Centor and McIsaac Scores to predict group A streptococcal pharyngitis”. Arch. Intern. Med. 172 (11), 852– 853. 10.1001/archinternmed.2012.1741 22566487 · DOI
  14. Chiappini E. Regoli M. Bonsignori F. Sollai S. Parretti A. Galli L. (2011). Analysis of different recommendations from international guidelines for the management of acute pharyngitis in adults and children. Clin. Ther. 33 (1), 48– 58. 10.1016/j.clinthera.2011.02.001 21397773 · DOI
  15. Cohen D. M. Russo M. E. Jaggi P. Kline J. Gluckman W. Parekh A. (2015). Multicenter Clinical Evaluation of the Novel Alere i Strep A Isothermal Nucleic Acid Amplification Test. J. Clin. Microbiol. 53 (7), 2258– 2261. 10.1128/JCM.00490-15 25972418 PMC4473182 · DOI
  16. Cohen J. F. Chalumeau M. Levy C. Bidet P. Benani M. Koskas M. (2013). Effect of clinical spectrum, inoculum size and physician characteristics on sensitivity of a rapid antigen detection test for group A streptococcal pharyngitis. Eur. J. Clin. Microbiol. Infect. Dis. 32 (6), 787– 793. 10.1007/s10096-012-1809-1 23340863 · DOI
  17. Cohen J. F. Bertille N. Cohen R. Chalumeau M. (2016). Rapid antigen detection test for group A streptococcus in children with pharyngitis. Cochrane Database Syst. Rev. 7, CD010502. 10.1002/14651858.CD010502.pub2 27374000 PMC6457926 · DOI
  18. Cohen J. F. Pauchard J. Y. Hjelm N. Cohen R. Chalumeau M. (2020). Efficacy and safety of rapid tests to guide antibiotic prescriptions for sore throat. Cochrane Database Syst. Rev. 6, CD012431. 10.1002/14651858.CD012431.pub2 32497279 PMC7271976 · DOI
  19. Cohen J. F. Cohen R. Levy C. Thollot F. Benani M. Bidet P. (2015). Selective testing strategies for diagnosing group A streptococcal infection in children with pharyngitis: a systematic review and prospective multicentre external validation study. CMAJ 187 (1), 23– 32. 10.1503/cmaj.140772 25487666 PMC4284164 · DOI
  20. Cooper R. J. Hoffman J. R. Bartlett J. G. Besser R. E. Gonzales R. Hickner J. M. (2001). Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann. Intern. Med. 134 (6), 509– 517. 10.7326/0003-4819-134-6-200103200-00019 11255530 · DOI
  21. Daly J. A. Korgenski E. K. Munson A. C. Llausas-Magana E. (1994). Optical immunoassay for streptococcal pharyngitis: evaluation of accuracy with routine and mucoid strains associated with acute rheumatic fever outbreak in the intermountain area of the United States. J. Clin. Microbiol. 32 (2), 531– 532. 10.1128/JCM.32.2.531-532.1994 8150968 PMC263069 · DOI
  22. Demoré B. Tebano G. Gravoulet J. Wilcke C. Ruspini E. Birgé J. (2018). Rapid antigen test use for the management of group A streptococcal pharyngitis in community pharmacies. Eur. J. Clin. Microbiol. Infect. Dis. 37 (9), 1637– 1645. 10.1007/s10096-018-3293-8 29876774 · DOI
  23. Dimatteo L. A. Lowenstein S. R. Brimhall B. Reiquam W. Gonzales R. (2001). The relationship between the clinical features of pharyngitis and the sensitivity of a rapid antigen test: evidence of spectrum bias. Ann. Emerg. Med. 38 (6), 648– 652. 10.1067/mem.2001.119850 11719744 · DOI
  24. Dobbs F. (1996). A scoring system for predicting group A streptococcal throat infection. Br. J. Gen. Pract. 46 (409), 461– 464. 8949324 PMC1239715
  25. Donato L. J. Myhre N. K. Murray M. A. McDonah M. R. Myers J. F. Maxson J. A. (2019). Assessment of Test Performance and Potential for Environmental Contamination Associated with a Point-of-Care Molecular Assay for Group A Streptococcus in an End User Setting. J. Clin. Microbiol. 57 (2), e01629– e01718. 10.1128/JCM.01629-18 30518542 PMC6355544 · DOI
  26. Ebell M. H. Smith M. A. Barry H. C. Ives K. Carey M. (2000). The rational clinical examination. Does this patient have strep throat? Jama 284 (22), 2912– 2918. 10.1001/jama.284.22.2912 11147989 · DOI
  27. Essack S. Bell J. Shephard A. (2018). Community pharmacists-Leaders for antibiotic stewardship in respiratory tract infection. J. Clin. Pharm. Ther. 43 (2), 302– 307. 10.1111/jcpt.12650 29205419 · DOI
  28. Ezike E. N. Rongkavilit C. Fairfax M. R. Thomas R. L. Asmar B. I. (2005). Effect of using 2 throat swabs vs 1 throat swab on detection of group A streptococcus by a rapid antigen detection test. Arch. Pediatr. Adolesc. Med. 159 (5), 486– 490. 10.1001/archpedi.159.5.486 15867125 · DOI
  29. Farhan S A. M. Mahafza T. (2015). A Medical Decision Support System for ENT Disease Diagnosis using Artificial Neural Networks. Int. J. Artif. Intell. Mechatronics 4 (2), 45– 54.
  30. Felsenstein S. Faddoul D. Sposto R. Batoon K. Polanco C. M. Dien Bard J. (2014). Molecular and clinical diagnosis of group A streptococcal pharyngitis in children. J. Clin. Microbiol. 52 (11), 3884– 3889. 10.1128/JCM.01489-14 25143573 PMC4313219 · DOI
  31. Fine A. M. Nizet V. Mandl K. D. (2012). Large-scale validation of the Centor and McIsaac scores to predict group A streptococcal pharyngitis. Arch. Intern. Med. 172 (11), 847– 852. 10.1001/archinternmed.2012.950 22566485 PMC3627733 · DOI
  32. Forward K. R. Haldane D. Webster D. Mills C. Brine C. Aylward D. (2006). A comparison between the Strep A Rapid Test Device and conventional culture for the diagnosis of streptococcal pharyngitis. Can. J. Infect. Dis. Med. Microbiol. 17 (4), 221– 223. 10.1155/2006/696018 18382631 PMC2095077 · DOI
  33. Gerber M. A. Shulman S. T. (2004). Rapid diagnosis of pharyngitis caused by group A streptococci. Clin. Microbiol. Rev. 17 (3), 571– 80, table of contents. 10.1128/CMR.17.3.571-580.2004 15258094 PMC452552 · DOI
  34. Gerber M. A. Tanz R. R. Kabat W. Dennis E. Bell G. L. Kaplan E. L. (1997). Optical immunoassay test for group A beta-hemolytic streptococcal pharyngitis. An office-based, multicenter investigation. JAMA 277 (11), 899– 903. 10.1001/jama.277.11.899 9062328 · DOI
  35. Gerber M. A. Baltimore R. S. Eaton C. B. Gewitz M. Rowley A. H. Shulman S. T. (2009). Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation 119 (11), 1541– 1551. 10.1161/CIRCULATIONAHA.109.191959 19246689 · DOI
  36. Group E. S. T. G. Pelucchi C. Grigoryan L. Galeone C. Esposito S. Huovinen P. (2012). Guideline for the management of acute sore throat. Clin. Microbiol. Infect. 18 Suppl 1, 1– 28. 10.1111/j.1469-0691.2012.03766.x 22432746 · DOI
  37. Hall M. C. Kieke B. Gonzales R. Belongia E. A. (2004). Spectrum bias of a rapid antigen detection test for group A beta-hemolytic streptococcal pharyngitis in a pediatric population. Pediatrics 114 (1), 182– 186. 10.1542/peds.114.1.182 15231926 · DOI
  38. Harbeck R. J. Teague J. Crossen G. R. Maul D. M. Childers P. L. (1993). Novel, rapid optical immunoassay technique for detection of group A streptococci from pharyngeal specimens: comparison with standard culture methods. J. Clin. Microbiol. 31 (4), 839– 844. 10.1128/JCM.31.4.839-844.1993 8463394 PMC263574 · DOI
  39. Heiter B. J. Bourbeau P. P. (1995). Comparison of two rapid streptococcal antigen detection assays with culture for diagnosis of streptococcal pharyngitis. J. Clin. Microbiol. 33 (5), 1408– 1410. 10.1128/JCM.33.5.1408-1410.1995 7615768 PMC228180 · DOI
  40. Henson A. M. Carter D. Todd K. Shulman S. T. Zheng X. (2013). Detection of Streptococcus pyogenes by use of Illumigene group A Streptococcus assay. J. Clin. Microbiol. 51 (12), 4207– 4209. 10.1128/jcm.01892-13 24048538 PMC3838043 · DOI
  41. Humair J. P. Revaz S. A. Bovier P. Stalder H. (2006). Management of acute pharyngitis in adults: reliability of rapid streptococcal tests and clinical findings. Arch. Intern. Med. 166 (6), 640– 644. 10.1001/archinte.166.6.640 16567603 · DOI
  42. Joachim L. Campos D. Jr. Smeesters P. R. (2010). Pragmatic scoring system for pharyngitis in low-resource settings. Pediatrics 126 (3), e608– e614. 10.1542/peds.2010-0569 20696724 · DOI
  43. Komaroff A. L. Pass T. M. Aronson M. D. Ervin C. T. Cretin S. Winickoff R. N. (1986). The prediction of streptococcal pharyngitis in adults. J. Gen. Intern. Med. 1 (1), 1– 7. 10.1007/BF02596317 3534166 · DOI
  44. Kose E. Sirin Kose S. Akca D. Yildiz K. Elmas C. Baris M. (2016). The Effect of Rapid Antigen Detection Test on Antibiotic Prescription Decision of Clinicians and Reducing Antibiotic Costs in Children with Acute Pharyngitis. J. Trop. Pediatr. 62 (4), 308– 315. 10.1093/tropej/fmw014 26999012 · DOI
  45. Kumar S. Little P. Britten N. (2003). Why do general practitioners prescribe antibiotics for sore throat? Grounded theory interview study. Bmj 326 (7381), 138. 10.1136/bmj.326.7381.138 12531847 PMC140007 · DOI
  46. Lacroix L. Cherkaoui A. Schaller D. Manzano S. Galetto-Lacour A. Pfeifer U. (2018). Improved Diagnostic Performance of an Immunofluorescence-based Rapid Antigen Detection Test for Group A Streptococci in Children With Pharyngitis. Pediatr. Infect. Dis. J. 37 (3), 206– 211. 10.1097/INF.0000000000001825 29135828 · DOI
  47. Langlois D. M. Andreae M. (2011). Group A streptococcal infections. Pediatr. Rev. 32 (10), 423– 9; quiz 30. 10.1542/pir.32-10-423 21965709 · DOI
  48. Le Marechal F. Martinot A. Duhamel A. Pruvost I. Dubos F. (2013). Streptococcal pharyngitis in children: a meta-analysis of clinical decision rules and their clinical variables. BMJ Open 3 (3), e001482. 10.1136/bmjopen-2012-001482 PMC3612811 23474784 · DOI
  49. Lean W. L. Arnup S. Danchin M. Steer A. C. (2014). Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis. Pediatrics 134 (4), 771– 781. 10.1542/peds.2014-1094 25201792 · DOI
  50. Linder J. A. Stafford R. S. (2001). Antibiotic treatment of adults with sore throat by community primary care physicians: a national survey, 1989-1999. JAMA 286 (10), 1181– 1186. 10.1001/jama.286.10.1181 11559262 · DOI
  51. Linder J. A. Bates D. W. Lee G. M. Finkelstein J. A. (2005). Antibiotic treatment of children with sore throat. JAMA 294 (18), 2315– 2322. 10.1001/jama.294.18.2315 16278359 · DOI
  52. Linder J. A. Chan J. C. Bates D. W. (2006). Evaluation and treatment of pharyngitis in primary care practice: the difference between guidelines is largely academic. Arch. Intern. Med. 166 (13), 1374– 1379. 10.1001/archinte.166.13.1374 16832002 · DOI
  53. Little P. Hobbs F. D. Moore M. Mant D. Williamson I. McNulty C. (2013). Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). BMJ 347, f5806. 10.1136/bmj.f5806 24114306 PMC3805475 · DOI
  54. Llor C. Madurell J. Balague-Corbella M. Gomez M. Cots J. M. (2011). Impact on antibiotic prescription of rapid antigen detection testing in acute pharyngitis in adults: a randomised clinical trial. Br. J. Gen. Pract. 61 (586), e244– e251. 10.3399/bjgp11X572436 21619748 PMC3080229 · DOI
  55. Luo R. Sickler J. Vahidnia F. Lee Y. C. Frogner B. Thompson M. (2019). Diagnosis and Management of Group a Streptococcal Pharyngitis in the United States, 2011-2015. BMC Infect. Dis. 19 (1), 193. 10.1186/s12879-019-3835-4 30808305 PMC6390592 · DOI
  56. Matthys J. De Meyere M. van Driel M. L. De Sutter A. (2007). Differences among international pharyngitis guidelines: not just academic. Ann. Fam. Med. 5 (5), 436– 443. 10.1370/afm.741 17893386 PMC2000301 · DOI
  57. McIsaac W. J. Goel V. (1997). Sore throat management practices of Canadian family physicians. Fam. Pract. 14 (1), 34– 39. 10.1093/fampra/14.1.34 9061342 · DOI
  58. McIsaac W. J. White D. Tannenbaum D. Low D. E. (1998). A clinical score to reduce unnecessary antibiotic use in patients with sore throat. Cmaj 158 (1), 75– 83. 9475915 PMC1228750
  59. McIsaac W. J. Goel V. To T. Low D. E. (2000). The validity of a sore throat score in family practice. CMAJ 163 (7), 811– 815. 11033707 PMC80502
  60. McIsaac W. J. Kellner J. D. Aufricht P. Vanjaka A. Low D. E. (2004). Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA 291 (13), 1587– 1595. 10.1001/jama.291.13.1587 15069046 · DOI
  61. Nakhoul G. N. Hickner J. (2013). Management of adults with acute streptococcal pharyngitis: minimal value for backup strep testing and overuse of antibiotics. J. Gen. Intern. Med. 28 (6), 830– 834. 10.1007/s11606-012-2245-8 23054930 PMC3663957 · DOI
  62. Needham C. A. McPherson K. A. Webb K. H. (1998). Streptococcal pharyngitis: impact of a high-sensitivity antigen test on physician outcome. J. Clin. Microbiol. 36 (12), 3468– 3473. 10.1128/JCM.36.12.3468-3473.1998 9817856 PMC105223 · DOI
  63. Neuner J. M. Hamel M. B. Phillips R. S. Bona K. Aronson M. D. (2003). Diagnosis and management of adults with pharyngitis. A cost-effectiveness analysis. Ann. Intern. Med. 139 (2), 113– 122. 10.7326/0003-4819-139-2-200307150-00011 12859161 · DOI
  64. Nyquist A. C. Gonzales R. Steiner J. F. Sande M. A. (1998). Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA 279 (11), 875– 877. 10.1001/jama.279.11.875 9516004 · DOI
  65. Pfoh E. Wessels M. R. Goldmann D. Lee G. M. (2008). Burden and economic cost of group A streptococcal pharyngitis. Pediatrics 121 (2), 229– 234. 10.1542/peds.2007-0484 18245412 · DOI
  66. Plainvert C. Duquesne I. Touak G. Dmytruk N. Poyart C. (2015). In vitro evaluation and comparison of 5 rapid antigen detection tests for the diagnosis of beta-hemolytic group A streptococcal pharyngitis. Diagn. Microbiol. Infect. Dis. 83 (2), 105– 111. 10.1016/j.diagmicrobio.2015.06.012 26159722 · DOI
  67. Ralph A. P. Holt D. C. Islam S. Osowicki J. Carroll D. E. Tong S. Y. C. (2019). Potential for Molecular Testing for Group A Streptococcus to Improve Diagnosis and Management in a High-Risk Population: A Prospective Study. Open Forum Infect. Dis. 6 (4), ofz097. 10.1093/ofid/ofz097 31011589 PMC6469435 · DOI
  68. Rogo T. Schwartz R. H. Ascher D. P. (2011). Comparison of the Inverness Medical Acceava Strep A test with the Genzyme OSOM and Quidel QuickVue Strep A tests. Clin. Pediatr. (Phila.) 50 (4), 294– 296. 10.1177/0009922810385675 21098521 · DOI
  69. Ruiz-Aragon J. Rodriguez Lopez R. Molina Linde J. M. (2010). [Evaluation of rapid methods for detecting Streptococcus pyogenes. Systematic review and meta-analysis]. Pediatr. (Barc.) 72 (6), 391– 402. 10.1016/j.anpedi.2009.12.012 20346743 · DOI
  70. Safizadeh Shabestari S. A. Malik Z. A. Al-Najjar F. Y. A. (2019). Diagnostic accuracy of QuickVue(R) Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates. BMC Pediatr. 19 (1), 429. 10.1186/s12887-019-1761-7 31711445 PMC6844028 · DOI
  71. Shaikh N. Swaminathan N. Hooper E. G. (2012). Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: a systematic review. J. Pediatr. 160 (3), 487– 93 e3. 10.1016/j.jpeds.2011.09.011 22048053 · DOI
  72. Sheridan E. Ludwig J. Helmen J. Thevatheril I. T. (2007). Clinical inquiries. Should you treat a symptomatic patient by phone when his child has confirmed strep throat? J. Fam. Pract. 56 (3), 234– 235. 17343817
  73. Shulman S. T. Bisno A. L. Clegg H. W. Gerber M. A. Kaplan E. L. Lee G. (2012). Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin. Infect. Dis. 55 (10), 1279– 1282. 10.1093/cid/cis847 23091044 · DOI · Paper page
  74. Singh S. Dolan J. G. Centor R. M. (2006). Optimal management of adults with pharyngitis–a multi-criteria decision analysis. BMC Med. Inform Decis. Mak 6, 14. 10.1186/1472-6947-6-14 16533386 PMC1431519 · DOI
  75. Snow V. Mottur-Pilson C. Cooper R. J. Hoffman J. R. (2001). Principles of appropriate antibiotic use for acute pharyngitis in adults. Ann. Intern. Med. 134 (6), 506– 508. 10.7326/0003-4819-134-6-200103200-00018 11255529 · DOI
  76. Spinks A. Glasziou P. P. Del Mar C. B. (2013). Antibiotics for sore throat. Cochrane Database Syst. Rev. 11, CD000023. 10.1002/14651858.CD000023.pub4 PMC6457983 24190439 · DOI
  77. Stefaniuk E. Bosacka K. Wanke-Rytt M. Hryniewicz W. (2017). The use of rapid test QuikRead go(R) Strep A in bacterial pharyngotonsillitis diagnosing and therapeutic decisions. Eur. J. Clin. Microbiol. Infect. Dis. 36 (10), 1733– 1738. 10.1007/s10096-017-2986-8 28429165 · DOI
  78. Stewart E. H. Davis B. Clemans-Taylor B. L. Littenberg B. Estrada C. A. Centor R. M. (2014). Rapid antigen group A streptococcus test to diagnose pharyngitis: a systematic review and meta-analysis. PloS One 9 (11), e111727. 10.1371/journal.pone.0111727 25369170 PMC4219770 · DOI
  79. Tan T. Little P. Stokes T. Guideline Development G (2008). Antibiotic prescribing for self limiting respiratory tract infections in primary care: summary of NICE guidance. BMJ 337, a437. 10.1136/bmj.a437 18650239 · DOI
  80. Tanz R. R. Gerber M. A. Kabat W. Rippe J. Seshadri R. Shulman S. T. (2009). Performance of a rapid antigen-detection test and throat culture in community pediatric offices: implications for management of pharyngitis. Pediatrics 123 (2), 437– 444. 10.1542/peds.2008-0488 19171607 · DOI
  81. Tanz R. R. Ranniger E. J. Rippe J. L. Dietz R. L. Oktem C. L. Lowmiller C. L. (2019). Highly Sensitive Molecular Assay for Group A Streptococci Over-identifies Carriers and May Impact Outpatient Antimicrobial Stewardship. Pediatr. Infect. Dis. J. 38 (8), 769– 774. 10.1097/INF.0000000000002293 30747832 · DOI
  82. Teratani Y. Hagiya H. Koyama T. Ohshima A. Zamami Y. Tatebe Y. (2019). Association between rapid antigen detection tests and antibiotics for acute pharyngitis in Japan: A retrospective observational study. J. Infect. Chemother. 25 (4), 267– 272. 10.1016/j.jiac.2018.12.005 30642770 · DOI
  83. Uhl J. R. Patel R. (2016). Fifteen-Minute Detection of Streptococcus pyogenes in Throat Swabs by Use of a Commercially Available Point-of-Care PCR Assay. J. Clin. Microbiol. 54 (3), 815. 10.1128/JCM.03387-15 26763964 PMC4767987 · DOI
  84. Uhl J. R. Adamson S. C. Vetter E. A. Schleck C. D. Harmsen W. S. Iverson L. K. (2003). Comparison of LightCycler PCR, rapid antigen immunoassay, and culture for detection of group A streptococci from throat swabs. J. Clin. Microbiol. 41 (1), 242– 249. 10.1128/jcm.41.1.242-249.2003 12517855 PMC149598 · DOI
  85. Van Brusselen D. Vlieghe E. Schelstraete P. De Meulder F. Vandeputte C. Garmyn K. (2014). Streptococcal pharyngitis in children: to treat or not to treat? Eur. J. Pediatr. 173 (10), 1275– 1283. 10.1007/s00431-014-2395-2 25113742 · DOI
  86. van Driel M. L. De Sutter A. I. Habraken H. Thorning S. Christiaens T. (2016). Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst. Rev. 9, CD004406. 10.1002/14651858.CD004406.pub4 27614728 PMC6457741 · DOI
  87. Van T. T. Mata K. Dien Bard J. (2019). Automated Detection of Streptococcus pyogenes Pharyngitis by Use of Colorex Strep A CHROMagar and WASPLab Artificial Intelligence Chromogenic Detection Module Software. J. Clin. Microbiol. 57 (11), e00811– e00819. 10.1128/JCM.00811-19 31434725 PMC6812993 · DOI · Paper page
  88. Walsh B. T. Bookheim W. W. Johnson R. C. Tompkins R. K. (1975). Recognition of streptococcal pharyngitis in adults. Arch. Intern. Med. 135 (11), 1493– 1497. 10.1001/archinte.135.11.1493 1103766 · DOI
  89. Wang F. Tian Y. Chen L. Luo R. Sickler J. Liesenfeld O. (2017). Accurate Detection of Streptococcus pyogenes at the Point of Care Using the cobas Liat Strep A Nucleic Acid Test. Clin. Pediatr. (Phila.) 56 (12), 1128– 1134. 10.1177/0009922816684602 28006981 · DOI
  90. Webb K. H. (1998). Does culture confirmation of high-sensitivity rapid streptococcal tests make sense? A medical decision analysis. Pediatrics 101 (2), E2. 10.1542/peds.101.2.e2 9445512 · DOI
  91. Weinzierl E. P. Jerris R. C. Gonzalez M. D. Piccini J. A. Rogers B. B. (2018). Comparison of Alere i Strep A Rapid Molecular Assay With Rapid Antigen Testing and Culture in a Pediatric Outpatient Setting. Am. J. Clin. Pathol. 150 (3), 235– 239. 10.1093/ajcp/aqy038 29931106 · DOI
  92. Wessels M. R. (2011). Clinical practice. Streptococcal pharyngitis. N Engl. J. Med. 364 (7), 648– 655. 10.1056/NEJMcp1009126 21323542 · DOI
  93. Wigton R. S. Connor J. L. Centor R. M. (1986). Transportability of a decision rule for the diagnosis of streptococcal pharyngitis. Arch. Intern. Med. 146 (1), 81– 83. 10.1001/archinte.1986.00360130103014 3510600 · DOI
  94. Worrall G. Hutchinson J. Sherman G. Griffiths J. (2007). Diagnosing streptococcal sore throat in adults: randomized controlled trial of in-office aids. Can. Fam. Physician 53 (4), 666– 671. 17872717 PMC1952596
  95. Xu J. Schwartz K. Monsur J. Northrup J. Neale A. V. (2004). Patient-clinician agreement on signs and symptoms of ‘strep throat’: a MetroNet study. Fam. Pract. 21 (6), 599– 604. 10.1093/fampra/cmh604 15528291 · DOI

Cited by

Sorted by citations

Authors
Mustafa, Z., & Ghaffari, M.
Affiliations
University of California, Riverside (US)
Corresponding author
Ghaffari, Masoumeh
ORCID
Mustafa, Zahid
Venue
Frontiers in Cellular and Infection Microbiology
Publisher
Frontiers Media SA
Published
2020-10-15
Volume
10
Pages
563627-563627
ISSN
2235-2988 (ISSN-L)
DOI
10.3389/fcimb.2020.563627
PMC
PMC7593338
OpenAlex
W3093398883
Cited by
102
References
0
Citations by year
2026: 13 · 2025: 18 · 2024: 24 · 2023: 26 · 2022: 14 · 2021: 7
FWCI
1.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Cellular and Infection Microbiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Infectious Diseases › Otolaryngology and Infectious Diseases
Keywords
Streptococcus pyogenes, streptococcal pharyngitis, acute pharyngitis, diagnostic methods, rapid antigen test, throat culture, nucleic acid amplification tests, clinical scoring systems, clinical guidelines, antibiotic therapy, narrow-spectrum antibiotics, guideline adherence, AI-assisted diagnosis, suppurative complications
MeSH terms
Adult, Anti-Bacterial Agents, Artificial Intelligence, Child, Humans, Pharyngitis, Streptococcal Infections, Streptococcus pyogenes, United States

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review