The pharyngitis is confirmed by a rapid antigen detection

The most common causational agent of Streptococcal pharyngitis is bacteria Streptococcus pyogenes, a part of group A strep (GAS). It affects
20—30 % of children and 5-15 % adult’s sore throats.  However, the diagnosis will be determining if
the patients has both the bacterial and viral pathogens. The pharyngitis itself
is caused by the viral component. In the past, clear observational diagnosis was
done, but the actual diagnosis of the group A strep pharyngitis is confirmed by
a rapid antigen detection test (RADT) or a throat culture. Rapid strep tests
have a specificity of 95 %, which means that the risk of a false positive is approximately
5 %. Although, the sensitivity of throat rapid strep test has a range of 80-90
% and in that sense, has a negative rate ranges of 10-20 %.

The test itself will have the
patient’s throat swabbed to collect a mucus sample. The sample will have
exposure to reagent that have antibodies binding to the GAS antigen. If the
test results are positive, then there will be a clear response. The test itself
has three variations. A latex fixation test is the least used and no longer
relevant. It is described as latex beads enclosed with antigens that will
adhere around the antigen. Though, the latex flow test is the most used, the
sample is paced on a nitrocellulose film, if the antigen is present a line will
form by the movement of labeled antibodies. The third choice is the optical
immunoassay. The sample is mixed with antibodies and a distinctive substrate,
which will change colors in the presence of the GAS. The test is the most
expensive and not used as commonly.

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Pharmacological
treatment of strep pharyngitis is usually self-limiting and resolves on its
own.  However, the most common treatment
is the use of antibiotics. Antibiotics will reduce the number of days for
symptoms with relief seen within 72 hours. Penicillin, penicillin congeners,
and certain cephalosporin and macrolides are effective. Based on safety and
cost, patients are given a regime of penicillin recommended by AAP,19 the
American Heart Association,20 the Infectious Diseases Society of America
(IDSA),2 and the World Health Organization for the treatment of streptococcal
pharyngitis. Current U.S guidelines are oral penicillin- children 250 mg twice
or three time daily for 10 days. Adults are to take 250 mg three to four times
daily for 10 days. If the patients have a penicillin allergy, erythromycin ethylsuccinate.

The regime for children is 30 to 50 mg per kilogram in two to four divided
doses. The adult dosing is increases to 40 mg four times per day or 800 mg two
times per day. Both regimes are for 10 days. If recurrence occurs within the prior
28 days then the patient may have to have intramuscular penicillin administered
as a option when the oral antibiotics were first prescribed.   When treating
the patient, there must be consideration of recurrent infection within the
family, people who are at risk for exposure for acute rheumatic fever or acute
poststreptococcal glomerulonephritis.