Ninety children between 2 and 15 years of age with acute pharyngitis symptoms suggesting GAS etiology (MCS 鈮?#xA0;2), participated in our study. At the initial visit MCS was evaluated and two throat swabs were collected to perform RADT and culture. In children with GAS pharyngitis treated with penicillin, microbiological cure was assessed by performing two control throat cultures. Next, children were under observation for 3 months.
Positive predictive value of score 4 in MCS turned out to be 48.05% (95% CI: 36.5-59.7%). RADT sensitivity, specificity and diagnostic accuracy proved to be 100%, 96%, and 98%, respectively. GAS eradication rate in children treated with penicillin turned out to be 92.5%. No post-streptococcal sequelae occurred in any child in 3-month observation.
Empiric antibiotic therapy in children with score 4 in MCS will result in significant overtreatment of those with nonstreptococcal pharyngitis. New generation RADT diagnostic value in GAS detection proved to be equivalent to that of culture, which obviates the need of backup culture in children with negative RADT results. Phenoxymethyl penicillin revealed high eradication efficacy and proved to prevent post-streptococcal sequelae in children with acute GAS pharyngitis.