Abstract：
The most common cause of bacterial pharyngitis is Group A Streptococcus (GAS). Accurate diagnosis of GAS pharyngitis is crucial to identify children who would benefit from antibiotic treatment. Rapid diagnosis has the potential to reduce antibiotic overuse. Current national guidelines differ in their recommendations for GAS testing. While rapid antigen detection tests (RADTs) are widely used, their sensitivity is considered too low for stand-alone testing by several expert bodies. Newer molecular tests using nucleic acid amplification show higher accuracy and fast results, but their cost, complexity, and very high sensitivity may limit widespread adoption. This review provides up-to-date evidence regarding rapid diagnostic testing and antimicrobial stewardship in children with sore throat. We discuss discrepancies across GAS testing guidelines at the international level, patient selection for testing for GAS, rapid test accuracy, and the potential role of rapid GAS tests to promote antibiotic stewardship, with emphasis on emerging rapid molecular tests.
摘要：
细菌性咽炎的最常见原因是A组链球菌（GAS）。准确诊断GAS咽炎对于确定将从抗生素治疗中受益的儿童至关重要。快速诊断有可能减少抗生素的过度使用。当前的国家指南对GAS测试的建议有所不同。虽然快速抗原检测试验被广泛使用,几个专家机构认为它们的灵敏度太低，无法进行独立测试。使用核酸扩增的较新的分子测试显示出更高的准确性和快速的结果，但是他们的成本，复杂性，和非常高的灵敏度可能会限制广泛采用。这篇综述提供了有关喉咙痛儿童的快速诊断测试和抗菌药物管理的最新证据。我们在国际层面上讨论了GAS测试指南之间的差异，选择患者进行GAS测试，快速测试精度，以及快速GAS测试对促进抗生素管理的潜在作用，重点是新兴的快速分子测试。
