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Clinical Pediatrics
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Throat Culture Is Necessary After Negative Rapid Antigen Detection Tests

Ayesha Mirza, MD

Pediatric Infectious Diseases and Immunology, University of Florida Health Science Center

Peter Wludyka, PhD

University of North Florida Center for Research and Consulting in Statistics, Jacksonville, Florida

Thomas T. Chiu, MD, MBA

Department of Pediatrics, University of Florida Health Science Center

Mobeen H. Rathore, MD

Pediatric Infectious Diseases and Immunology, University of Florida Health Science Center, Wolfson Children's Hospital

This study was conducted to determine if culture confirmation is needed for a negative rapid antigen detection test. Data on 18 509 tests done in patients younger than 18 years old were reviewed. Of the 14 167 (76.5%) that were negative, 968 (6.8%) were associated with positive cultures. No significant seasonal variation was noted. Significant differences were found between hospital and pediatric practices in the percentage of patients with a negative rapid antigen detection test who actually had group A ß-hemolytic streptococcus (3.5% to 9.8%). This study supports the recommendation of culture confirmation of a negative rapid antigen detection test and validation of results within an individual practice if confirmatory cultures are not being performed. This study showed a high false-negative rate of the negative rapid antigen detection test and variation among hospital and pediatric practices for rates of positive culture after a negative rapid antigen detection test.

Key Words: group A ß-hemolytic streptococcus • rapid antigen detection tests • throat culture.

Clinical Pediatrics, Vol. 46, No. 3, 241-246 (2007)
DOI: 10.1177/0009922806290219
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