Skip to main content
Top
Gepubliceerd in: Huisarts en wetenschap 4/2013

01-04-2013 | Beschouwing

Acute keelpijn: de toegevoegde waarde van de streptest

Auteurs: Maartje Schouwenburg, Theo Verheij

Gepubliceerd in: Huisarts en wetenschap | Uitgave 4/2013

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

Schouwenburg MG, Verheij ThJM. Acute keelpijn: de toegevoegde waarde van de streptest. Huisarts Wet 2013;56(4):170-3.
In Nederland krijgen veel patiënten met acute keelpijn ten onrechte antibiotica. De waarde van een sneltest op groep-Astreptokokken, de zogeheten streptest, is onduidelijk. Daarom bespreken we in dit literatuuroverzicht de toegevoegde waarde van deze test in de huisartsenpraktijk. Uit de relevante onderzoeken bleek de positief voorspellende waarde 70-90% en de negatief voorspellende waarde 85-95%. Deze hoge diag nostische waarden maken de streptest mogelijk waardevol als aanvulling op de huidige aanpak, die uitgaat van het klinisch beeld. Vooral bij patiënten die relatief veel klinische verschijnselen hebben, zal de test waarschijnlijk leiden tot een relevante daling van onnodig gebruik van antibiotica, ook in Nederland. Nader onderzoek in de Nederlandse huisartsenpraktijk zal moeten uitwijzen of deze aanname juist is.
Literatuur
go back to reference Van der Linden MW, Westert GP, De Bakker DH, Schellevis FG. Tweede Nationale Studie naar ziekten en verrichtingen in de huisartspraktijk: Klachten en aandoeningen in de bevolking en in de huisartspraktijk. Utrecht/Bilthoven: NIVEL/RIVM, 2004. Van der Linden MW, Westert GP, De Bakker DH, Schellevis FG. Tweede Nationale Studie naar ziekten en verrichtingen in de huisartspraktijk: Klachten en aandoeningen in de bevolking en in de huisartspraktijk. Utrecht/Bilthoven: NIVEL/RIVM, 2004.
go back to reference Lindbæk M. Which is the best method to trace group A streptococci in sore throat patients: Culture or GAS antigen test? Scan J Prim Health Care 2004;22:233–8.CrossRef Lindbæk M. Which is the best method to trace group A streptococci in sore throat patients: Culture or GAS antigen test? Scan J Prim Health Care 2004;22:233–8.CrossRef
go back to reference Zwart S, Sachs AP, Ruijs GJ, Gubbels JW, Hoes AW, De Melker RA. Penicillin for acute sore throat: randomised double blind trial of seven days versus three days treatment or placebo in adults. BMJ 2000;320:150–4.PubMedCrossRef Zwart S, Sachs AP, Ruijs GJ, Gubbels JW, Hoes AW, De Melker RA. Penicillin for acute sore throat: randomised double blind trial of seven days versus three days treatment or placebo in adults. BMJ 2000;320:150–4.PubMedCrossRef
go back to reference Spinks AB, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev 2006;CD000023 Spinks AB, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev 2006;CD000023
go back to reference Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making 1981;1:239–46.PubMedCrossRef Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making 1981;1:239–46.PubMedCrossRef
go back to reference Komaroff AL, Pass TM, Aronson MD, Ervin CT, Cretin S, Winickoff RN, et al. The prediction of streptococcal pharyngitis in adults. J Gen Intern Med 1986;1:1–7.PubMedCrossRef Komaroff AL, Pass TM, Aronson MD, Ervin CT, Cretin S, Winickoff RN, et al. The prediction of streptococcal pharyngitis in adults. J Gen Intern Med 1986;1:1–7.PubMedCrossRef
go back to reference McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A, Low DE. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA 2004;291:1587–95.PubMedCrossRef McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A, Low DE. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA 2004;291:1587–95.PubMedCrossRef
go back to reference Gerber MA, Shulman ST. Rapid diagnosis of pharyngitis caused by group A streptococci. Clin Microbiol Rev 2004;17:571–80.PubMedCrossRef Gerber MA, Shulman ST. Rapid diagnosis of pharyngitis caused by group A streptococci. Clin Microbiol Rev 2004;17:571–80.PubMedCrossRef
go back to reference Tanz RR, Gerber MA, Kabat W, Rippe J, Seshadri R, Shulman ST. Performance of a rapid antigen-detection test and throat culture in community pediatric offices: Implications for management of pharyngitis. Pediatrics 2009;123:437–44.PubMedCrossRef Tanz RR, Gerber MA, Kabat W, Rippe J, Seshadri R, Shulman ST. Performance of a rapid antigen-detection test and throat culture in community pediatric offices: Implications for management of pharyngitis. Pediatrics 2009;123:437–44.PubMedCrossRef
go back to reference Edmonson MB, Farwell KR. Relationship between clinical likelihood of group A streptococcal pharyngitis and the sensitivity of a rapid antigendetection test in a pediatric practice. Pediatrics 2005;115:280–5.PubMedCrossRef Edmonson MB, Farwell KR. Relationship between clinical likelihood of group A streptococcal pharyngitis and the sensitivity of a rapid antigendetection test in a pediatric practice. Pediatrics 2005;115:280–5.PubMedCrossRef
go back to reference Matthys J, De Meyere M, Van Driel ML, De Sutter A. Differences among international pharyngitis guidelines: Not just academic. Ann Fam Med 2007;5:436–43.PubMedCrossRef Matthys J, De Meyere M, Van Driel ML, De Sutter A. Differences among international pharyngitis guidelines: Not just academic. Ann Fam Med 2007;5:436–43.PubMedCrossRef
go back to reference Zwart S, Dagnelie CF, Van Staaij BK, Balder FA, Boukes FS, Starreveld JS. NHG-Standaard Acute keelpijn. Huisarts Wet 2007;50:59–68. Zwart S, Dagnelie CF, Van Staaij BK, Balder FA, Boukes FS, Starreveld JS. NHG-Standaard Acute keelpijn. Huisarts Wet 2007;50:59–68.
go back to reference Akkerman AE, Kuyvenhoven MM, Van der Wouden JC, Verheij TJ. Determinants of antibiotic overprescribing in respiratory tract infections in general practice. J Antimicrob Chemother 2005;56:930–6.PubMedCrossRef Akkerman AE, Kuyvenhoven MM, Van der Wouden JC, Verheij TJ. Determinants of antibiotic overprescribing in respiratory tract infections in general practice. J Antimicrob Chemother 2005;56:930–6.PubMedCrossRef
go back to reference Van Deursen AM, Verheij TJ, Rovers MM, Veenhoven RH, Groenwold RH, Bonten MJ, et al.. Trends in primary-care consultations, comorbidities and antibiotic prescriptions for respiratory infections in The Netherlands before implementation of pneumococcal vaccines for infants. Epidemiol Infect 2012;140:823–34.PubMedCrossRef Van Deursen AM, Verheij TJ, Rovers MM, Veenhoven RH, Groenwold RH, Bonten MJ, et al.. Trends in primary-care consultations, comorbidities and antibiotic prescriptions for respiratory infections in The Netherlands before implementation of pneumococcal vaccines for infants. Epidemiol Infect 2012;140:823–34.PubMedCrossRef
go back to reference Rimoin AW, Walker CLF, Hamza HS, Elminawi N, Ghafar HA, Vince A, et al. The utility of rapid antigen detection testing for the diagnosis of streptococcal pharyngitis in low-resource settings. Int J Infect Dis 2010;12:e1048–53.CrossRef Rimoin AW, Walker CLF, Hamza HS, Elminawi N, Ghafar HA, Vince A, et al. The utility of rapid antigen detection testing for the diagnosis of streptococcal pharyngitis in low-resource settings. Int J Infect Dis 2010;12:e1048–53.CrossRef
go back to reference Llor C, Calvino O, Hernandez S, Crispi S, Pérez-Bauer M, Fernández Y, et al. Repetition of the rapid antigen test in initially negative supposed streptococcal pharyngitis is not necessary in adults. Int J Clin Pract 2009;63:1340–4.PubMedCrossRef Llor C, Calvino O, Hernandez S, Crispi S, Pérez-Bauer M, Fernández Y, et al. Repetition of the rapid antigen test in initially negative supposed streptococcal pharyngitis is not necessary in adults. Int J Clin Pract 2009;63:1340–4.PubMedCrossRef
go back to reference Humair JP, Revaz SA, Bovier P, Stalder H. Management of acute pharyngitis in adults: Reliability of rapid streptococcal tests and clinical findings. Arch Intern Med 2006;166:640–4.PubMedCrossRef Humair JP, Revaz SA, Bovier P, Stalder H. Management of acute pharyngitis in adults: Reliability of rapid streptococcal tests and clinical findings. Arch Intern Med 2006;166:640–4.PubMedCrossRef
go back to reference Nerbrand C, Jasir A, Schalen C. Are current rapid detection tests for group A streptococci sensitive enough? Evaluation of 2 commercial kits. Scand J Infect Dis 2002;34:797–9.PubMedCrossRef Nerbrand C, Jasir A, Schalen C. Are current rapid detection tests for group A streptococci sensitive enough? Evaluation of 2 commercial kits. Scand J Infect Dis 2002;34:797–9.PubMedCrossRef
go back to reference Dagnelie CF, Bartelink ML, Van der Graaf Y, Goessens W, De Melker RA. Towards a better diagnosis of throat infections (with group A beta-haemolytic streptococcus) in general practice. Br J Gen Pract 1998;48:959–62.PubMed Dagnelie CF, Bartelink ML, Van der Graaf Y, Goessens W, De Melker RA. Towards a better diagnosis of throat infections (with group A beta-haemolytic streptococcus) in general practice. Br J Gen Pract 1998;48:959–62.PubMed
go back to reference Gunnarsson RK, Holm SE, Söderström M. The prevalence of beta-haemolytic streptococci in throat specimens from healthy children and adults: Implications for the clinical value of throat cultures. Scand J Prim Health Care 1997;15:149–55.PubMedCrossRef Gunnarsson RK, Holm SE, Söderström M. The prevalence of beta-haemolytic streptococci in throat specimens from healthy children and adults: Implications for the clinical value of throat cultures. Scand J Prim Health Care 1997;15:149–55.PubMedCrossRef
go back to reference ESCMID Sore Throat Guideline Group; Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, et al. Guideline for the management of acute sore throat. Clin Microbiol Infect 2012;18 Suppl 1:1–28. ESCMID Sore Throat Guideline Group; Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, et al. Guideline for the management of acute sore throat. Clin Microbiol Infect 2012;18 Suppl 1:1–28.
go back to reference Llor C, Madurell J, Balagué-Corbella M, Gómez M, Cots JM. Impact on antibiotic prescription of rapid antigen detection testing in acute pharyngitis in adults: A randomised clinical trial. Br J Gen Pract 2011;61:e244–51.CrossRef Llor C, Madurell J, Balagué-Corbella M, Gómez M, Cots JM. Impact on antibiotic prescription of rapid antigen detection testing in acute pharyngitis in adults: A randomised clinical trial. Br J Gen Pract 2011;61:e244–51.CrossRef
go back to reference Worral G, Hutchinson J, Sherman G, Griffiths J. Diagnosing streptococcal sore throat in adults: Randomized controlled trial of in-office aids. Can Fam Phys 2007;53:667–71. Worral G, Hutchinson J, Sherman G, Griffiths J. Diagnosing streptococcal sore throat in adults: Randomized controlled trial of in-office aids. Can Fam Phys 2007;53:667–71.
go back to reference Maltezou HC, Tsagris V, Antoniadou A, Galani L, Douros C, Katsarolis I, et al. Evaluation of a rapid antigen detection test in the diagnosis of streptococcal pharyngitis in children and its impact on antibiotic prescription. J Antimicrob Chemother 2008;62:1407–12.PubMedCrossRef Maltezou HC, Tsagris V, Antoniadou A, Galani L, Douros C, Katsarolis I, et al. Evaluation of a rapid antigen detection test in the diagnosis of streptococcal pharyngitis in children and its impact on antibiotic prescription. J Antimicrob Chemother 2008;62:1407–12.PubMedCrossRef
Metagegevens
Titel
Acute keelpijn: de toegevoegde waarde van de streptest
Auteurs
Maartje Schouwenburg
Theo Verheij
Publicatiedatum
01-04-2013
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Huisarts en wetenschap / Uitgave 4/2013
Print ISSN: 0018-7070
Elektronisch ISSN: 1876-5912
DOI
https://doi.org/10.1007/s12445-013-0096-0

Andere artikelen Uitgave 4/2013

Huisarts en wetenschap 4/2013 Naar de uitgave