일차의료기관에서 세균성 인두염의 진단검사 비교 및 제언

초록

There are more than 10 million visits to primary care clinics annually due to pharyngitis or tonsillitis. The antibiotic prescription rate for these patients is more than 50%. An optimal diagnosis is necessary to avoid antibiotic misuse or overuse. Here, we compared the benefits and pitfalls of three currently available laboratory methods, such as throat culture, rapid antigen detection test (RADT), and molecular tests. We also reviewed the current American and Korean guidelines for bacterial pharyngitis. Although throat culture is regarded as a gold standard, it requires high technical expertise and culture facilities. In addition, the turn-around time (TAT) is 1 day-2 days causing possible inadequate prescription as well as the inconvenience of a second clinical visit to check results. The RADT does not require culture facilities and the TAT is noticeably short (5-10 min). The initial low sensitivity of the RADT has been improved these days. Though molecular tests are the most advanced, there remains a lack of clinical data. Therefore, we recommend judicious use of the RADT for diagnosing bacterial pharyngitis as well as effective antibiotic prescriptions at primary care clinics.

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