Abstract

Introduction: Acute tonsillopharyngitis caused by Group A beta-hemolytic streptococcus (GABHS) is a common condition in pediatric populations, often leading to the overprescription of antibiotics. This is a pressing issue both in Vietnam and globally, where accurate diagnosis plays a crucial role in reducing antibiotic overuse and mitigating Antimicrobial Resistance (AMR). This study evaluates the effectiveness of the Strep A Rapid Antigen Detection Test (RADT) in diagnosing GABHS and reducing inappropriate antibiotic prescriptions in children at Children’s Hospital 1, Ho Chi Minh City.

Methods: A cross-sectional study was conducted on 200 children with fever and/or sore throat, diagnosed with acute tonsillopharyngitis. Symptoms were assessed using the Modified Centor Score, and the Strep A RADT was performed to confirm GABHS infection. The study evaluated the impact of Strep A RADT on antibiotic prescription rates and its applicability in clinical practice.

Results: Among the 200 patients aged 1 to 15 years (mean age 6.39 ± 3.05 years), 39% tested positive for GABHS. The RADT demonstrated a sensitivity of 87.3% and specificity of 95.8%. Antibiotic prescriptions were reduced by 57.5%, from 96.5% pre-RADT to 39% post-RADT. This reduction highlights the role of Strep A RADT in minimizing unnecessary antibiotic use, improving antibiotic stewardship, and combating AMR.

Conclusions: Strep A RADTs are advantageous due to their high sensitivity, specificity, ease of use, and short turnaround time. The combination of this RADT with the Modified Centor Score is beneficial in reducing unnecessary antibiotic prescriptions by up to 57.5%.