Rapid antigenic diagnostic test: determinants of use, clinical orientation and economic impact in primary health care

Authors

  • Bárbara Duarte Ferreira Médica de Medicina Geral e Familiar. USF Novo Norte, ULS de Entre Douro e Vouga. Arouca, Portugal.
  • Carolina Pais Neto Médica de Medicina Geral e Familiar. USF Novo Norte, ULS de Entre Douro e Vouga. Arouca, Portugal.
  • Cátia Almeida Médica de Medicina Geral e Familiar. USF Novo Norte, ULS de Entre Douro e Vouga. Arouca, Portugal.
  • Susana Oliveira Faculdade de Economia do Porto. Porto, Portugal.

DOI:

https://doi.org/10.32385/rpmgf.v41i5.14191

Keywords:

Acute tonsillitis, RADT, Antibiotherapy, Cost-effectiveness

Abstract

Introduction: Acute tonsillitis is a common reason for seeking medical evaluation in primary health care (PHC) in pediatric age. Although the majority of cases have a viral etiology, 35% are caused by bacteria and, consequently, require antibiotic treatment. The use of rapid antigenic diagnostic tests (RADTs) aids in both diagnosis and the identification of the most common causal agent.

Objectives: (1) Assessment of the importance of using RADT in the diagnostic and therapeutic guidance of patients; and (2) estimation of the costs of a large-scale use of RADT and whether this use could result in a reduction in the costs of treating these patients.

Methods: An observational, retrospective, and descriptive study was conducted between January 2021 and May 2024 at the ULS of Entre Douro e Vouga units. The sample is made up of pediatric patients diagnosed with acute tonsillitis. The statistical analysis was carried out using SPSS.

Results: Eight hundred and thirty-two episodes of acute tonsillitis were analyzed, most of them in FHU-B. In these, RADT was used in 66.1% of cases. The use of RADT contributed to significantly lower antibiotic prescriptions, as well as a reduced need for reevaluation consultations. The age of the clinician, the clinician’s gender, and the type of PHC unit were important factors in both the use of the test and antibiotic prescription. Economically, the implementation of RADT does not increase the cost of the medical procedure and results in a significant reduction in the total cost of the treatment.

Conclusion: The use of RADT proves to be a crucial tool in diagnosing and identifying the etiological agent in patients with acute tonsillitis, thereby improving therapeutic guidance and reducing the costs associated with their treatment.

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References

1. Direção-Geral da Saúde. Diagnóstico e tratamento da amigdalite aguda na idade pediátrica: norma nº 020/2012, de 26/12/2012. Lisboa: DGS; 2012.

2. Vicedomini D, Lalinga G, Lugli N, D'Avino A. Diagnosi e gestione della faringotonsillite acuta nell'ambulatorio del pediatra di famiglia [Diagnosis and management of acute pharyngotonsillitis in the primary care pediatrician's office]. Minerva Pediatr. 2014;66(1):69-76. Italian

3. Schroeder BM. Diagnosis and management of group A streptococcal pharyngitis. Am Fam Physician. 2003;67(4):880, 883-4.

4. Mourão P, Palma RM. Amigdalofaringite aguda: proposta de abordagem baseada na evidência [Acute tonsillopharyngitis: an evidence-based approach]. Rev Port Clin Geral. 2002;18(6):385-98. Portuguese

5. Stefaniuk E, Bosacka K, Wanke-Rytt M, Hryniewicz W. The use of rapid test QuikRead go® Strep A in bacterial pharyngotonsillitis diagnosing and therapeutic decisions. Eur J Clin Microbiol Infect Dis. 2017;36(10):1733-8.

6. Santos R, Mesquita P, Mendes T, Coelho R, Vale L. Ter ou não ter, eis a questão: o impacto da disponibilidade de identificação microbiológica [To have or not to have, that is the question: the impact of the availability of microbiological identification]. Acta Med Port. 2021;34(2):159. Portuguese

7. Pulcini C, Pauvif L, Paraponaris A, Verger P, Ventelou B. Perceptions and attitudes of French general practitioners towards rapid antigen diagnostic tests in acute pharyngitis using a randomized case vignette study. J Antimicrob Chemother. 2012;67(6):1540-6.

8. Spurgeon D. Standard of care by doctors may drop with years spent in practice. BMJ. 2005;330(7488):384.

9. Baumhäkel M, Müller U, Böhm M. Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure in a cross-sectional study. Eur J Heart Fail. 2009;11(3):299-303.

10. Rochon PA, Gruneir A, Bell CM, Savage R, Gill SS, Wu W, et al. Comparison of prescribing practices for older adults treated by female versus male physicians: a retrospective cohort study. PLoS One. 2018;13(10):e0205524.

11. Xue H, Liu G, Shi Y, Nie J, Auden E, Sylvia S. How does physician gender influence primary care quality? Evidence from a standardised patient audit study in China. Lancet. 2018;392(spec. issue):S66.

12. Meier FA, Howland J, Johnson J, Poisson R. Effects of a rapid antigen test for group A streptococcal pharyngitis on physician prescribing and antibiotic costs. Arch Intern Med. 1990;150(8):1696-700.

13. Ehrlich JE, Demopoulos BP, Daniel KR Jr, Ricarte MC, Glied S. Cost-effectiveness of treatment options for prevention of rheumatic heart disease from group A streptococcal pharyngitis in a pediatric population. Prev Med. 2002;35(3):250-7.

14. Kose E, Sirin Kose S, Akca D, Yildiz K, Elmas C, Baris M, et al. The effect of rapid antigen detection test on antibiotic prescription decision of clinicians and reducing antibiotic costs in children with acute pharyngitis. J Trop Pediatr. 2016;62(4):308-15.

15. Giraldez-Garcia C, Rubio B, Gallegos-Braun JF, Imaz I, Gonzalez-Enriquez J, Sarria-Santamera A. Diagnosis and management of acute pharyngitis in a paediatric population: a cost-effectiveness analysis. Eur J Pediatr. 2011;170(8):1059-67.

16. Ayanruoh S, Waseem M, Quee F, Humphrey A, Reynolds T. Impact of rapid streptococcal test on antibiotic use in a pediatric emergency department. Pediatr Emerg Care. 2009;25(11):748-50.

Published

2025-11-03

How to Cite

Rapid antigenic diagnostic test: determinants of use, clinical orientation and economic impact in primary health care. (2025). Portuguese Journal of Family Medicine and General Practice, 41(5), 397-405. https://doi.org/10.32385/rpmgf.v41i5.14191

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