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Background Rapid antigen detection testing (RADT) is needed to differentiate Group A Streptococcal (GAS) pharyngitis from viral pharyngitis. Guidelines do not recommend RADT in patients with viral symptoms or in children Methods Retrospective chart review of 1,085 healthy children, age 1–5 years old, seen in clinics between September 2015 and March 2019 (355 pre- and 730 post-education; 211 academic and 874 private). Education occurred in 3/2017. Cases selected had either complaint of sore throat, RADT, or diagnosis of GAS pharyngitis or pharyngitis. Data collected included the presence of viral symptoms (e.g., cough, rhinorrhea), RADT/GAS culture results, diagnosis, and prescribed antibiotics. RADT was deemed unnecessary for all children < 3 years old without GAS exposure, in patients with ≥ 2 viral symptoms, or in patients ≥ 3 years old without pharyngitis. Results Overall, RADT use decreased from pre to post intervention (72.1% vs. 23.4% of patients, P ≤ 0.0001). Unnecessary RADT use decreased overall (50.4% vs. 16.2%, P ≤ 0.0001), in all clinics (private: 56.2% vs. 16.0%, P ≤ 0.0001; academic: 38.1% vs. 17.4%, P = 0.0012), and with all providers (physician: 41.6% vs. 18.3%, P ≤ 0.0001; APRN: 58.8% vs. 14.1%, P ≤ 0.0001). Unnecessary RADT use decreased for children Conclusion Unnecessary RADT use decreased in the post-education period overall (34%), in children Disclosures All authors: No reported disclosures. |
