Esen Elif Serap, Egici Memet Taskin, Ozturk Guzin Zeren
Department of Family Medicine, University of Health Sciences Turkey, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2020 Jun 10;54(2):201-205. doi: 10.14744/SEMB.2018.01336. eCollection 2020.
Unnecessary use of antibiotics is one of the causes of antibiotic resistance. Rapid Antigen Test (RAT) is recommended to prevent unnecessary use of antibiotics by providing bacteria/virus isolation in patients with tonsillopharyngitis. However, in patients with typical symptoms, false-negative test results may lead to doubt in doctors. In this study, we aimed to evaluate the relationship between patients' symptoms and RAT results.
In this study, we chose the patients that referred to the University of Health Sciences (SBÜ) Şişli Hamidiye Etfal Training and Research Hospital Family Medicine Polyclinics and got a diagnosis of tonsillopharyngitis with RAT. This study was conducted by a retrospective file scanning method. We examined the age, sex, symptoms, RAT results and throat culture results of the patients. SPSS 15.0 for Windows program was used for the statistical analysis. The level of statistical significance was accepted as p<0.05.
In this study, the RAT of 265 patients and the throat culture of 141 patients were examined. We found RAT positivity as 28.7%, Group A Beta Hemolytic Streptococcus (AGBHS) detection rate in throat culture was 22.5%, and the antibiotic prescription rate was 37%. There were 32 patients with AGBHS positivity in throat culture. Twenty-seven of them got RAT positivity, too. When symptoms and RAT positivity were examined, there was no significant relationship between RAT positivity and fever higher than 38 oC, but RAT was more often positive in patients with a fever higher than 38 oC. On the other hand, there is a statistically significant relationship between RAT positivity and the presence of tonsillar exudate (p=0.000). When the relationship between symptoms and RAT according to age groups was examined, the presence of LAP and tonsillitis were significant (p=0.000; p=0.001). In the age group of 18 years and over, the presence of tonsillar exudates was significant (p=0.001).
In our study, tonsillar exudate was a common symptom in both age groups of <18, and ≥18 years of age; at the same time, there is a statistically significant relation with RAT. Tonsillar exudates are not seen only in bacterial infections but also in viral infections. Thus, we think that antibiotics should not be started based on symptoms, and RAT should be used effectively.
抗生素的不必要使用是抗生素耐药性的原因之一。推荐使用快速抗原检测（RAT），通过对扁桃体咽炎患者进行细菌/病毒分离来防止抗生素的不必要使用。然而，对于有典型症状的患者，检测结果为假阴性可能会使医生产生怀疑。在本研究中，我们旨在评估患者症状与RAT检测结果之间的关系。
在本研究中，我们选取了前往健康科学大学（SBÜ）锡什利哈米迪耶埃法尔培训与研究医院家庭医学门诊就诊并通过RAT诊断为扁桃体咽炎的患者。本研究采用回顾性病历扫描方法。我们检查了患者的年龄、性别、症状、RAT检测结果和咽喉培养结果。使用SPSS 15.0 for Windows程序进行统计分析。统计学显著性水平设定为p<0.05。
在本研究中，对265例患者进行了RAT检测，对141例患者进行了咽喉培养。我们发现RAT阳性率为28.7%，咽喉培养中A组β溶血性链球菌（AGBHS）检出率为22.5%，抗生素处方率为37%。咽喉培养中有32例AGBHS阳性患者。其中27例RAT检测也呈阳性。当检查症状与RAT阳性之间的关系时，RAT阳性与体温高于38℃之间无显著关系，但体温高于38℃的患者RAT检测更常呈阳性。另一方面，RAT阳性与扁桃体渗出物的存在之间存在统计学显著关系（p = 0.000）。当按年龄组检查症状与RAT之间的关系时，LAP和扁桃体炎的存在具有显著性（p = 0.000；p = 0.001）。在18岁及以上年龄组中，扁桃体渗出物的存在具有显著性（p = 0.001）。
在我们的研究中，扁桃体渗出物在18岁以下和18岁及以上两个年龄组中都是常见症状；同时，与RAT存在统计学显著关系。扁桃体渗出物不仅见于细菌感染，也见于病毒感染。因此，我们认为不应仅凭症状就开始使用抗生素，而应有效使用RAT。
