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Llor, CCorresponding AuthorHernandez, SAuthorMartinez, TAuthorGomez, F FAuthor

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Repetition of the rapid antigen test in initially negative supposed streptococcal pharyngitis is not necessary in adults

Publicated to:International Journal Of Clinical Practice. 63 (9): 1340-1344 - 2009-09-01 63(9), DOI: 10.1111/j.1742-1241.2009.02048.x

Authors: Llor, C; Calvino, O; Hernandez, S; Crispi, S; Perez-Bauer, M; Fernandez, Y; Martinez, T; Gomez, F F; Cots, J M

Affiliations

Hosp Joan 23, Dept Microbiol, Tarragona, Spain - Author
Univ Barcelona, Barcelona, Spain - Author
Univ Rovira & Virgili, Primary Care Ctr Jaume 11, Tarragona, Spain - Author

Abstract

Aims:To determine whether the repetition of the rapid antigen detection test (RADT) in patients, with a high suspicion of presenting pharyngitis by group A beta-haemolytic streptococci (GABHS), with a previously negative test improves the validity of the test.Methods:Two hundred and twenty-two patients aged 14 years or more with acute pharyngitis and two or more Centor criteria - tonsillar exudates, fever, tenderness in the lymph glands and/or absence of cough - were consecutively recruited. In all patients, a pharyngotonsillar sample was obtained with two swabs, one for the RADT (OSOM (R) Strep A Genzyme test, Genzyme Diagnostics, Cambridge, MA, USA) and the other was sent to the Department of Microbiology for culture. In patients with a negative RADT, the determination was repeated. The sensitivity, specificity and predictive values were determined.Results:Cultures were positive for GABHS in 55 patients (24.8%). Three false-negatives and 14 false-positives were observed by comparing the rapid test with throat culture, achieving a sensitivity of 94.5% and a specificity of 91.6%. Positive and negative predictive values were 78.8% and 98.1% respectively. Taking the second determination in the negative cases into account, the results were 96.4%, 91.6%, 79.1% and 98.7% respectively.Conclusions:The negative predictive value achieved with the RADT determination was very high. Repetition of the test only slightly improved this percentage, making repetition of this test unnecessary.

Keywords

ChildrenCultureDiagnosisGroup-a streptococcusPyogenes pharyngitisSore throatValidation

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal International Journal Of Clinical Practice due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2009, it was in position 31/133, thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine, General & Internal.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 1.57, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-28, the following number of citations:

  • WoS: 8
  • Scopus: 10

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-28:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 11 (PlumX).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Llor Vila, Carlos) .

the author responsible for correspondence tasks has been Llor Vila, Carlos.