Template:RADT algorithm

Rapid Antigen Detection Test Algorithm for Acute Pharyngitis[1]

Category Testing and Treatment
Clinical features strongly suggesting viral etiology (eg. cough, rhinorrhea, hoarseness, oral ulcers)
  • None
<3 years old
  • None because immature immune system not mature enough to develop anti-streptolysin O (ASO) antibodies and acute rheumatic fever[2].
    • Unless they have a special risk factor (e.g. older sibling with GAS infection)
CENTOR = 1
  • None
None of the above with CENTOR ≥2
  • Send rapid antigen detection test
    • Positive = treat
    • Negative
      • Children and adolescents
        • Send back up throat culture (treat later, if positive)
      • Adults
        • None (no need for back up throat culture)

Diagnostic testing or empiric treatment of asymptomatic household contacts of patients with acute streptococcal pharyngitis is not routinely recommended

  1. Shulman, et al. Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases 2012;55(10):1279–82
  2. David Cisewski An Understated Myth? Strep Throat & Rheumatic Fever