[Introduction of rapid streptococcal antigen test: can its use improve adherence to antibiotic therapy?]

Abstract

OBJECTIVE\nTo evaluate the influence of the result of a rapid streptococcal antigen test in paediatric pharyngotonsillitis infections, in terms of improvement of antibiotic therapy adherence.\n\n\nDESIGN\nRandomized community clinical trial with two study groups.\n\n\nLOCATION\nPrimary Care Centers in Central Catalonia.\n\n\nPARTICIPANTS\nPatients aged from 3 to 15 years, who were attended at paediatric consultations on suspicion of pharyngotonsillitis caused by an infection between November 2010 and February 2011 (both included), were included in the study on a consecutive basis. 557 patients met the inclusion criteria and 519 were evaluated.\n\n\nINTERVENTION\nThe control group received the usual diagnostic-therapeutic algorithm. Rapid streptococcal antigen test was additionally performed to experimental group participants and it was indicated the more convenient treatment.\n\n\nMAIN MEASUREMENTS\nAntibiotic adherence, non-adherence causes and socio-demographic risk factors were evaluated via telephone survey.\n\n\nRESULTS\nAntibiotics were prescribed to 65.6% and paediatricians of the control group were more likely to prescribe antibiotic than the ones in the intervention group (88.5% vs 45.5%, p< 0.0001). 64.8% followed doctor s treatment orders, being failure following medication scheduling the main cause of non-adherence (25.6%). Medication adherence was higher in the experimental group (68%) than in the control group (62.9%) but no significant differences were found.\n\n\nCONCLUSION\nRapid strep test, complementing the use of Centor Criteria avoids unnecessary antibiotics prescriptions, but had not been proven to be effective in increasing medication adherence.