scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y. A. Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Throat Culture ◽  
Negative Results ◽  
Tract Infections

Abstract Background Unnecessary antibiotic prescription to patients with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods A single-gated diagnostic accuracy study of children with fever, runny nose, and tonsillitis presenting to a paediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the test were calculated. Results Two hundred four children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of 5 years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 99.9%, 100%). Only 42 children ( 20.6%) were given antibiotics, while 162 (79.4%) were not. Conclusion The QV-SAT is a quick and reliable test that can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Throat Culture ◽  
Tract Infections

Abstract Background: Unnecessary antibiotic prescription to patients with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods: A single-gated diagnostic accuracy study of children with fever, runny nose, and tonsillitis presenting to a paediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. Furthermore, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios of the test were calculated. Results: 204 children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of five years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 70%, 95%). Only 42 children (21%) were given antibiotics, while 162 (79%) were not. Conclusion: The QV-SAT is a quick and reliable test that can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Throat Culture ◽  
Tract Infections

Abstract Background: Unnecessary antibiotic prescription to patients with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods: A single-gated diagnostic accuracy study of children with runny nose, fever, and tonsillitis presenting to a paediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. Furthermore, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios of the test were calculated. Results: 204 children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of five years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 70%, 95%). Only 42 children (21%) were given antibiotics, while 162 (79%) were not. Conclusion: The QV-SAT is a quick and reliable test which can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Throat Culture ◽  
Tract Infections

Abstract Background: Unnecessary antibiotic prescription to children with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods: A single-gated diagnostic accuracy study of children with acute catarrh, fever, and inflamed tonsils presenting to a pediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. Diagnostic accuracy of the QV-SAT was achieved by estimating the area under the ROC curve (AUC). Furthermore, the positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios of the test were calculated. Results: 204 children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of five years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 70%, 95%). Only 42 children (21%) were given antibiotics, while 162 (79%) were not. Conclusion: The QV-SAT is a quick and reliable test which can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

scholarly journals Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates

2019 ◽  
Author(s):  
Seyed Ali Safizadeh Shabestari ◽  
Zainab A. Malik ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sample Collection ◽  
Likelihood Ratios ◽  
Throat Culture ◽  
Tract Infections

Abstract Background: Unnecessary antibiotic prescription to patients with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. Methods: A single-gated diagnostic accuracy study of children with runny nose, fever, and tonsillitis presenting to a paediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. Furthermore, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios of the test were calculated. Results: 204 children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of five years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A β- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 70%, 95%). Only 42 children (21%) were given antibiotics, while 162 (79%) were not. Conclusion: The QV-SAT is a quick and reliable test which can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

Antibiotics and the development of resistant microorganisms. Can homeopathy be an alternative?

Homeopathy ◽  
2003 ◽  
Vol 92 (02) ◽  
pp. 99-107
Author(s):  
Petter Viksveen
Keyword(s):  
Antibiotic Resistance ◽  
Public Health Problem ◽  
Animal Husbandry ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Global Public Health ◽  
Agricultural Applications ◽  
Tract Infections ◽  
Almost All

AbstractAntibiotic resistance is a global public health problem. Once confined primarily to hospitals it is now increasingly common in primary care. The prevalence of resistant bacteria is rising, and organisms resistant to almost all antibiotics have been identified. The main causes are indiscriminate prescribing and the use of antibiotics in animal feeds and other agricultural applications. Policies to restrict use of antibiotics have had limited success. Homeopathy may have a role to play in combating the development of antibiotic resistance. Clinical research suggests that homeopathy is effective in the treatment of upper respiratory tract infections in children, a frequent cause of inappropriate antibiotic prescribing. The EU recommends the use of homeopathy in organic animal husbandry, and it is used by significant numbers of farmers. At present there is little data on the effectiveness of homeopathy in this setting. Further research should be done.

scholarly journals High diagnostic accuracy of automated rapid Strep A test reduces antibiotic prescriptions for children in the United Arab Emirates

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salama Bin Hendi ◽  
Zainab A. Malik ◽  
Amar Hassan Khamis ◽  
Fadil Y. A. Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
High Sensitivity ◽  
Signs And Symptoms ◽  
Throat Culture ◽  
Clinical Criteria ◽  
Variable Sensitivity ◽  
High Level ◽  
Sensitivity Specificity

Abstract Background Diagnosis of Group A Streptococcus (GAS) pharyngitis in children is hindered by variable sensitivity of clinical criteria and rapid Strep A tests (SAT), resulting in reliance on throat cultures as the gold standard for diagnosis. Delays while awaiting culture reports result in unnecessary antibiotic prescriptions among children, contributing to the spread of antimicrobial resistance (AMR). Methods Diagnostic accuracy study of an automated SAT (A-SAT) in children up to 16 years of age presenting to an emergency room with signs and symptoms of pharyngitis between March and June 2019. Paired throat swabs for A-SAT and culture were collected. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for A-SAT were calculated. Results Two hundred and ninety-one children were included in this study. 168 (57.7%) were boys and the mean age was 4.2 years. A-SAT was positive in 94 (32.3%) and throat culture was positive in 90 (30.9%) children. A-SAT and throat culture results showed a high level of consistency in our cohort. Only 6 (2%) children had inconsistent results, demonstrating that the A-SAT has a high sensitivity (98.9%), specificity (97.5%), PPV (94.7%) and NPV (99.5%) for the diagnosis of GAS pharyngitis in children. Only 92 (32%) children were prescribed antibiotics while the vast majority (68%) were not. Conclusions A-SAT is a quick and reliable test with diagnostic accuracy comparable to throat culture. Its widespread clinical use can help limit antibiotic prescriptions to children presenting with pharyngitis, thus limiting the spread of AMR.

scholarly journals #6: High Diagnostic Accuracy of Automated Rapid Strep A Test Reduces Antibiotic Prescriptions for Children in the United Arab Emirates.

2021 ◽  
Vol 10 (Supplement_2) ◽  
pp. S17-S17
Author(s):  
Salama Bin Hendi ◽  
Zainab A Malik ◽  
Amar Hassan Khamis ◽  
Fadil Y A Al-Najjar
Keyword(s):  
Diagnostic Accuracy ◽  
United Arab Emirates ◽  
Predictive Value ◽  
Group A Streptococcus ◽  
High Sensitivity ◽  
Signs And Symptoms ◽  
Throat Culture ◽  
Clinical Criteria ◽  
High Level ◽  
Sensitivity Specificity

Abstract Background Diagnosis of Group A Streptococcus (GAS) pharyngitis in children is hindered by variable sensitivity of clinical criteria and rapid Strep A tests (SAT), resulting in reliance on throat cultures as the gold standard for diagnosis. Delays while awaiting culture reports result in unnecessary antibiotic prescriptions among children, contributing to the spread of antimicrobial resistance (AMR). Methods Diagnostic accuracy study of an automated SAT (A-SAT) in children up to 16 years of age presenting to an emergency room with signs and symptoms of pharyngitis between March and June 2019. Paired throat swabs for A-SAT and culture were collected. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for A-SAT were calculated. Results Two hundred and ninety-one children were included in this study. 168 (57.7%) were boys and the mean age was 4.2 years. A-SAT was positive in 94 (32.3%) and throat culture was positive in 90 (30.9%) children. A-SAT and throat culture results showed a high level of consistency in our cohort. Only 6 (2%) children had inconsistent results, demonstrating that the A-SAT has a high sensitivity (98.9%), specificity (97.5%), PPV (94.7%) and NPV (99.5%) for the diagnosis of GAS pharyngitis in children. Only 92 (32%) children were prescribed antibiotics while the vast majority (68%) were not. Conclusions A-SAT is a quick and reliable test with diagnostic accuracy comparable to throat culture. Its widespread clinical use can help limit antibiotic prescriptions to children presenting with pharyngitis, thus limiting the spread of AMR.

scholarly journals Inappropriate Azithromycin Use in Nine Primary-Care Clinics Before and After Implementation of Provider Guidance in the EMR

2020 ◽  
Vol 41 (S1) ◽  
pp. s292-s293
Author(s):  
Alexandria May ◽  
Allison Hester ◽  
Kristi Quairoli ◽  
Sheetal Kandiah
Keyword(s):  
Primary Care ◽  
Retrospective Chart Review ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
National Guidelines ◽  
Targeted Interventions ◽  
Primary Care Clinics ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Background: According to the CDC Core Elements of Outpatient Stewardship, the first step in optimizing outpatient antibiotic use the identification of high-priority conditions in which antibiotics are commonly used inappropriately. Azithromycin is a broad-spectrum antimicrobial commonly used inappropriately in clinical practice for nonspecific upper respiratory infections (URIs). In 2017, a medication use evaluation at Grady Health System (GHS) revealed that 81.4% of outpatient azithromycin prescriptions were inappropriate. In an attempt to optimize outpatient azithromycin prescribing at GHS, a tool was designed to direct the prescriber toward evidence-based therapy; it was implemented in the electronic medical record (EMR) in January 2019. Objective: We evaluated the effect of this tool on the rate of inappropriate azithromycin prescribing, with the goal of identifying where interventions to improve prescribing are most needed and to measure progress. Methods: This retrospective chart review of adult patients prescribed oral azithromycin was conducted in 9 primary care clinics at GHS between February 1, 2019, and April 30, 2019, to compare data with that already collected over a 6-month period in 2017 before implementation of the antibiotic prescribing guidance tool. The primary outcome of this study was the change in the rate of inappropriate azithromycin prescribing before and after guidance tool implementation. Appropriateness was based on GHS internal guidelines and national guidelines. Inappropriate prescriptions were classified as inappropriate indication, unnecessary prescription, excessive or insufficient treatment duration, and/or incorrect drug. Results: Of the 560 azithromycin prescriptions identified during the study period, 263 prescriptions were included in the analysis. Overall, 181 (68.8%) of azithromycin prescriptions were considered inappropriate, representing a 12.4% reduction in the primary composite outcome of inappropriate azithromycin prescriptions. Bronchitis and unspecified upper respiratory tract infections (URI) were the most common indications where azithromycin was considered inappropriate. Attending physicians prescribed more inappropriate azithromycin prescriptions (78.1%) than resident physicians (37.0%) or midlevel providers (37.0%). Also, 76% of azithromycin prescriptions from nonacademic clinics were considered inappropriate, compared with 46% from academic clinics. Conclusions: Implementation of a provider guidance tool in the EMR lead to a reduction in the percentage of inappropriate outpatient azithromycin prescriptions. Future targeted interventions and stewardship initiatives are needed to achieve the stewardship program’s goal of reducing inappropriate outpatient azithromycin prescriptions by 20% by 1 year after implementation.Funding: NoneDisclosures: None

Sign in / Sign up

Export Citation Format

Share Document