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Is It Necessary to Double-Check Strep Tests?

Is It Necessary to Double-Check Strep Tests?

Sore throats are a common ailment in the United States, and they often indicate that a person has suffered a strep throat infection. Fortunately, testing for sore throat is a quick and rather painless process. To make certain that the initial test results are accurate, doctors often send throat swabs to medical laboratories, where they are given a more detailed analysis. But what if this precaution wasn’t necessary?

A 2012 study by researchers at the Cleveland Clinic examined this very issue. This undertaking required a good deal of effort, since the authors gathered medical records from 25,000 adult patients. All of these subjects had sought treatment at the Cleveland Clinic for sore throats. The data was collected over a period of two years.

Of this group of selected patients, roughly 20,000 had undergone an in-office testing for strep throat. The tests for most of these individuals came back negative, as strep was only detected in about 3,000 patients. In addition to this in-office testing, swabs from 15,500 patients were also sent away for more thorough examination. Fortunately, this action largely confirmed the results of the original tests, with a small number of samples (953 cases, or six percent of the amount tested) coming back positive for strep.

Antibiotic Overuse

Though most patients tested for strep did not have this infection, many were still prescribed antibiotics. In fact, among those with negative results on both initial and secondary tests, the researchers found that 45 percent were given such medications. Antibiotics were also being used by half of those in the late-diagnosis group – before the results of the laboratory testing were even known.

The authors argue that antibiotics are used too often to treat sore throats, a view that is certainly shared by others. According to the Infectious Diseases Society of America, antibiotics are effective for just 5 to 15 percent of adults with this ailment. Taking antibiotics when they are not necessary can contribute to antibiotic resistance, a development in which antibiotics lose their effectiveness in combating harmful bacteria. The issue has so concerned the Centers for Disease Control and Prevention (CDC) that the agency has launched its “Get Smart” program, which aims to curb antibiotic overuse through educational methods.

An Expensive Medical Bill

Aside from being unnecessary, the authors of the study also stress that backup tests for strep throat come at a hefty price. At the Cleveland Clinic, these tests ring up a tab of $113 apiece. Since so many strep throat tests are conducted every year, the overall price tag for insurance companies and patients is quite intimidating. For this study alone, the bill for strep testing came to a whopping $1.7 million.

Furthermore, misleading in-office tests did not have a major impact on the patients’ health. In the 953 cases where strep was found on secondary testing, none of the patients suffered any health-related complications involving strep throat. Because of this lack of additional symptoms, the researchers contend that the backup testing for strep fails a cost-benefit analysis. The report appeared in the June 2013 issue of the Journal of General Internal Medicine.

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