Abstract
To the Editor.— Drs Kellogg and Manzella 1 are to be congratulated for their review of the complicated subject of testing for streptococcal pharyngitis. However, I feel some important aspects of such testing may warrant further clarification. The primary reason for testing is to find patients with active infection. The best way to determine this, as the authors allude to early in their article, is to demonstrate a significant antibody titer rise between the acute and the convalescent serum samples of patients. Titers are not clinically helpful for an individual patient but serve as our against which other should be compared. Instead, as the authors document, most recent studies on throat cultures use other throat cultures as the standard comparison. 2 Now, the new rapid strep tests are being evaluated with throat culture results, not by comparing them with the gold standard of antibody titer rise. 1,3
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