The method wasn’t perfect: It meant 8,500 strep cases would have been missed, or the diagnosis delayed, concluded the government-funded study.
But Mandl said it’s unlikely that would lead to lasting harm as most of those infections would clear up on their own, or persisting pain eventually would send patients to the doctor. And he noted that the rapid strep tests that doctors use in their offices can miss cases, too.
Much more research is needed to prove if the method would work in everyday life and if a mobile app or a phone call to the doctor would be the best approach. The Boston team has begun the next step: Parents of kids who come to the hospital’s emergency room for a strep test are handed a digital tablet and asked to fill out the scorecard first. Researchers will see how the combination of symptoms and local infection trends compare with actual strep test results.
Sore throats are a challenge. Strep throat, caused by bacteria named Group A streptococcus, is to blame for only about 10 percent of cases in adults, and 30 percent in children.
It’s hard to tell who needs a strep test based on symptoms alone, cautioned Dr. Chris Van Beneden of the Centers for Disease Control and Prevention, which helped fund the new research. But what is clear: Doctors should be sure it’s strep before prescribing antibiotics because those bacteria-fighting drugs have no effect on viruses.
Yet research published last month in the journal JAMA Internal Medicine found 60 percent of adults who sought care for a sore throat received antibiotics. Unneeded antibiotic use can spur development of drug-resistant germs.
The Boston team looked at the flip side of the issue: Who could safely skip a strep check? Because strep is most common in children ages 5 to 15, doctors usually test youngsters with a sore throat for the bacteria.