Rapid Strep Testing in Children With Recent Streptococcal Pharyngitis

NCT ID: NCT03055728

Last Updated: 2018-06-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

600 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-05-09

Study Completion Date

2018-01-16

Brief Summary

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The purpose of this study is to determine if the rapid antigen detection test for Group A streptococcal pharyngitis diagnosis might yield higher rates of false positive results in patients who have been treated for GAS pharyngitis within 28 days of the test.

Detailed Description

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Strep pharyngitis, or strep throat, is a common infection afflicting children, aged 2 and above. Testing for strep pharyngitis consists of a rapid test and/or a throat culture. However, it has been observed that rapid testing may not be accurate in children with a recent history of strep pharyngitis. Therefore, this study aims to determine the accuracy of rapid strep testing in children who are presenting with symptoms of strep throat, who also have a recent history of and treatment for strep pharyngitis. By demonstrating an inaccuracy in rapid strep testing in patients with a recent history of strep pharyngitis, unnecessary testing and antibiotic use may be decreased, thereby reducing costs, overuse of antibiotics, and antibiotic resistance.

The participants in the study will include 600 children, aged 2 to 20 years old, selected from a private practice in Northern Virginia who present to the practice with signs or symptoms suggestive of acute pharyngitis. Subjects are children who are presenting with signs and symptoms suggestive of acute pharyngitis by the Centor criteria, including sore throat, fever, abdominal pain and cervical lymphadenitis. Any child with above presenting symptoms who is to undergo Streptococcus rapid antigen testing will be recruited to participate in the study.

A letter of consent will be provided to the parents and guardians of the involved child, stating that the study will be voluntary and confidential, and that all results will be kept in a safe environment.

Investigators will be testing the difference between two proportions, the false positive rate in previously treated compared to those not treated.

Conditions

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Streptococcal Infections

Study Design

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Observational Model Type

OTHER

Study Time Perspective

OTHER

Study Groups

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Group 1 / Study Group

Subjects presenting with signs or symptoms of acute pharyngitis, with a history of culture-proven GAS infection and subsequent 10-day antibiotic treatment within the preceding 28 days. Subjects will have a rapid strep antigen detection test and a throat culture to determine presence of strep.

Rapid strep antigen detection test

Intervention Type DIAGNOSTIC_TEST

Pharyngeal swab for rapid antigen detection of streptococcus

throat culture

Intervention Type DIAGNOSTIC_TEST

Pharyngeal swab for culture for bacteria (specifically streptococcus) presence

Group 2 / Control Group

Subjects presenting with signs or symptoms of acute pharyngitis, without a recent history of GAS infection. Subjects will have a rapid strep antigen detection test and a throat culture to determine presence of strep.

Rapid strep antigen detection test

Intervention Type DIAGNOSTIC_TEST

Pharyngeal swab for rapid antigen detection of streptococcus

throat culture

Intervention Type DIAGNOSTIC_TEST

Pharyngeal swab for culture for bacteria (specifically streptococcus) presence

Interventions

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Rapid strep antigen detection test

Pharyngeal swab for rapid antigen detection of streptococcus

Intervention Type DIAGNOSTIC_TEST

throat culture

Pharyngeal swab for culture for bacteria (specifically streptococcus) presence

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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rapid strep

Eligibility Criteria

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Inclusion Criteria

* 2-20 years old
* Current signs and symptoms suggestive of acute pharyngitis, including sore throat, fever, abdominal pain and cervical lymphadenitis.

Exclusion Criteria

* Potential subjects who have been treated with less than 10 days of antibiotic therapy
* Patients who report non-compliance with previous antibiotic therapy
* Patients who have already been included in the study and children with evidence of GAS carrier status
Minimum Eligible Age

2 Years

Maximum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Georgetown University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Amin Barakat, MD

Role: PRINCIPAL_INVESTIGATOR

Georgetown University Hospital

Locations

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Northern Virginia Pediatrics

Falls Church, Virginia, United States

Site Status

Countries

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United States

References

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Sheeler RD, Houston MS, Radke S, Dale JC, Adamson SC. Accuracy of rapid strep testing in patients who have had recent streptococcal pharyngitis. J Am Board Fam Pract. 2002 Jul-Aug;15(4):261-5.

Reference Type BACKGROUND
PMID: 12150457 (View on PubMed)

Edmonson MB, Farwell KR. Relationship between the clinical likelihood of group a streptococcal pharyngitis and the sensitivity of a rapid antigen-detection test in a pediatric practice. Pediatrics. 2005 Feb;115(2):280-5. doi: 10.1542/peds.2004-0907.

Reference Type BACKGROUND
PMID: 15687433 (View on PubMed)

McIsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998 Jan 13;158(1):75-83.

Reference Type BACKGROUND
PMID: 9475915 (View on PubMed)

Llor C, Calvino O, Hernandez S, Crispi S, Perez-Bauer M, Fernandez Y, Martinez T, Gomez FF, Cots JM. Repetition of the rapid antigen test in initially negative supposed streptococcal pharyngitis is not necessary in adults. Int J Clin Pract. 2009 Sep;63(9):1340-4. doi: 10.1111/j.1742-1241.2009.02048.x.

Reference Type BACKGROUND
PMID: 19691618 (View on PubMed)

Leung AK, Newman R, Kumar A, Davies HD. Rapid antigen detection testing in diagnosing group A beta-hemolytic streptococcal pharyngitis. Expert Rev Mol Diagn. 2006 Sep;6(5):761-6. doi: 10.1586/14737159.6.5.761.

Reference Type BACKGROUND
PMID: 17009909 (View on PubMed)

Other Identifiers

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2013-0388

Identifier Type: -

Identifier Source: org_study_id

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