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Most often, pharyngitis in children is caused by viruses and does not require antibiotic treatment. Confirmatory diagnosis of group A streptococcal (GAS) pharyngitis generally requires a throat culture or rapid diagnostic test (RDT), which takes additional time and increases cost. Can GAS be differentiated from other causes of pharyngitis solely on the basis of clinical criteria?
To find out, researchers searched MEDLINE (1950–2011) and Embase (1966–2011) for articles containing data on the accuracy of symptoms or signs for ruling in or ruling out GAS pharyngitis in children aged 3 to 18 years. Thirty-four articles (including 24,418 children) contained data on specific symptoms and signs, and 15 had data on prediction rules.
Historically, the…