Abstract
BackgroundDiagnosis and treatment of pharyngotonsillitis are commonly focused on group A streptococci (GAS), although the disease is often associated with other pathogens. While the incidence of pharyngotonsillitis is known to vary with season, seasonal variations in the prevalence of potential pathogens are sparsely explored. The aim of this study was to explore any seasonal variations in the use and outcome of rapid antigen detection tests (RADTs) for GAS and throat cultures among patients diagnosed with pharyngotonsillitis in primary care.MethodsWe retrieved and combined retrospective data from the electronic medical record system and the laboratory information system in Kronoberg County, Sweden. Primary care visits resulting in a diagnosis of tonsillitis or pharyngitis were included, covering the period 2013–2016. The monthly rate of visits was measured, along with the use and outcome of RADTs for GAS and throat cultures obtained on the date of diagnosis. The variations between calendar months were then analysed.ResultsWe found variations between calendar months, not only in the mean rate of visits resulting in a diagnosis of pharyngotonsillitis (p < 0.001), but in the mean proportion of RADTs being positive for GAS among the diagnosed (p < 0.001), and in the mean proportion of visits associated with a throat culture (p < 0.001). A lower mean rate of visits in August and September coincided with a lower proportion of RADTs being positive for GAS among them, which correlated with a higher proportion of visits associated with a throat culture.ConclusionsThis study suggests that the role of GAS in pharyngotonsillitis in Sweden is less prominent in August and September than during the rest of the year.
Highlights
Diagnosis and treatment of pharyngotonsillitis are commonly focused on group A streptococci (GAS), the disease is often associated with other pathogens
18% were positive for GAS, with the highest mean proportion in April (29%, 95% Confidence interval (CI) 21–39) and the lowest in September (11%, 95% CI 6–17), but the overall variation between the calendar months, comparing means for all months, was not statistically significant (p = 0.055)
A lower mean rate of visits in August and September coincided with a lower proportion of rapid antigen detection test (RADT) being positive for GAS among them, which correlated with a higher proportion of visits associated with a throat culture
Summary
Diagnosis and treatment of pharyngotonsillitis are commonly focused on group A streptococci (GAS), the disease is often associated with other pathogens. The aim of this study was to explore any seasonal variations in the use and outcome of rapid antigen detection tests (RADTs) for GAS and throat cultures among patients diagnosed with pharyngotonsillitis in primary care. In the Swedish official guideline, antibiotics are only recommended to patients with three or four Centor criteria, and a positive rapid antigen detection test (RADT) for GAS [4]. GAS are the most commonly found bacteria among adolescents and adults seeking medical care for pharyngotonsillitis, but the disease has been associated with a variety of pathogens, both bacteria and viruses, including polymicrobial cases [3, 7]. Asymptomatic colonization by different pathogens is prevalent [3, 7, 8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
