From Reuters Health Information
By Robert Saunders
NEW YORK (Reuters Health) Aug 09 - A substantial proportion of children with pharyngitis probably have group A streptococcal infection, a new meta-analysis shows. Furthermore, about one in every eight healthy kids is a carrier.
Those numbers are drawn from 29 studies with data on the prevalence of group A Streptococcus (GAS) in pharyngeal specimens in children younger than 18 years.
Writing online today in Pediatrics, lead author Dr. Nader Shaikh of Children's Hospital of Pittsburgh, Pennsylvania, and colleagues report that the prevalence of GAS in children presenting with sore throat is 37% overall and 24% in children younger than five.
In other words, Dr. Shaikh told Reuters Health, "Of school-aged children who present to their physicians with a sore throat, more than one third will have strep throat (which is much much higher than the rate in adult patients)."
The implications? "The relatively high probability of GAS disease and acute rheumatic fever in school-aged children, as compared with adults and children who are younger than 5 years, suggests that testing of school-aged children who present with sore throat is beneficial," the authors advise.
Twelve percent of asymptomatic kids over five carry GAS. "So it is probably not wise to test children who have absolutely no signs or symptoms of pharyngitis. This will lead to unnecessary antibiotic use," Dr. Shaikh said.
Posttreatment cultures are unnecessary in the majority of patients with GAS pharyngitis, the authors suggest. However, "In selected children with recurrent pharyngitis, posttreatment testing may help to differentiate children with true recurrent GAS pharyngitis from carriers; children who are carriers are likely to have persistent GAS even after being treated with appropriate antimicrobial agents."