True B L, Carter B L, Driscoll C E, House J D
J Fam Pract. 1986 Sep;23(3):215-9.
The sensitivity and specificity of a rapid identification test for group A beta-hemolytic streptococcus and its impact on prescribing antibiotics and ordering throat cultures were evaluated in a primary care office setting. The calculated sensitivity, specificity, positive predictive value, and negative predictive value were 82 percent, 92 percent, 76 percent, and 94 percent, respectively. Throat cultures were ordered for 98 percent of patients with acute pharyngitis regardless of the method of testing available. After use of the rapid identification test within the office, a reduction was observed in physician prescribing of antibiotics before the throat culture results were known. Physicians were more likely to initiate antibiotics immediately when rapid test results for streptococcal infection were positive and provide patient education regarding symptomatic treatment when the results were negative. The rapid identification test is an acceptable alternative to the standard culture technique in the family practice office. The rapid test was apparently responsible for the observed reduction in antibiotic prescribing and should reduce unnecessary cost and antibiotic exposure in the ambulatory setting.
在初级保健诊所环境中，对A组β溶血性链球菌快速鉴定试验的敏感性、特异性及其对开具抗生素处方和安排咽喉培养的影响进行了评估。计算得出的敏感性、特异性、阳性预测值和阴性预测值分别为82%、92%、76%和94%。无论采用何种检测方法，98%的急性咽炎患者都进行了咽喉培养。在诊所内使用快速鉴定试验后，观察到在咽喉培养结果出来之前，医生开具抗生素的情况有所减少。当链球菌感染快速检测结果为阳性时，医生更有可能立即开始使用抗生素，而当结果为阴性时，会为患者提供关于对症治疗的教育。在家庭医疗诊所中，快速鉴定试验是标准培养技术的可接受替代方法。快速试验显然是观察到的抗生素处方减少的原因，并且应该会降低门诊环境中不必要的成本和抗生素暴露。
