Hope some Doctor Doper out there has the answer to this - my doctors won’t give me a straight answer.
We just took our son to the pediatrician for a severe sore throat and they gave him this “rapid-result” strep test. He came out positive and is now on antibiotics.
Of course strep is on the “catchy” side so they suggested we all get tested.
I’m in the clear because 3 days ago I was put on the same antibiotic for a different malady (my doctor says I don’t need testing). My wife and daughter do need testing so they go in.
But they get this other test that needs 3 days to get results. When asked why not the rapid result test they’re told it’s inaccurate.
So what gives? If it’s inaccurate why are children guinea pigs? If it works, why isn’t it used on adults?
The suspicious side of me says they make more money if they use the old fashioned test (lab fees, etc.)
IANAD, but this is my guess. Presumably you understand why you’re not being tested: Since you’re already receiving the treatment, there’s no point. In the case of an obviously sick person, they want the results right away, so they do the quick one to confirm the diagnosis. If the others are not symptomatic, they are just trying to be sure, so it is o.k. to wait a few days.
My kids’ pediatrician told us that the quick test sometimes gives false negatives, so if they had a bad throat and the q.t. was negative, they would also administer the regular test. I would hazard a WAG that the quick test is more, not less expensive.
However, I don’t understand why you were told the results would take 3 days; the old-fashioned one we always had took overnight. Basically, they take a swab of the throat, put the goop on a petri dish and see what grows. If no strep germs grow overnight, then no antibiotics are indicated.
I’d wager that it’s all about cost. One test is more expensive, and/or is re-imbursed by insurance at a greater rate.
In most of the cases of strep I diagnosed, the test was just to CYA. One look at the throat was enough to ensure treatment. Very distinctive appearance. Also, when swabbing the throat for the test, if the patient doesn’t gag, you didn’t do it right.
The rapid strep test has a fairly high false negative rate. It’s worth doing on someone who’s symptomatic (and who therefore has a greatly increased chance of having strep throat) because there’s a high likelihood the test will be positive, and if it comes up positive you can start the kid on an appropriate antibiotic therapy that day instead of having to wait for cultures to grow - it saves a bit of time (and discomfort!). If the test comes up negative (less likely in a symptomatic person), then a conventional throat culture can be performed to rule out a false negative result.
But in someone who’s not symptomatic, the odds are the person isn’t sick with strep throat, so most of the time that rapid strep test is going to come up negative. But you can’t rely on a negative result from a rapid strep test to rule out strep throat - it could, after all, be a false negative. So you’re going to have to do a conventional throat culture anyway. Since the majority of the non-symptomatic folks are therefore going to end up needing a conventional throat culture to confirm the negative rapid strep test result, and they’re by definition not suffering so getting results quickly isn’t all that important, why bother with the rapid strep test at all? Just do the conventional throat culture and be done with it. It saves money.
It also reduces the chance of developing a resistant strain of bacteria from the antibiotic and can reduce the amount of time needed on the antibiotic.
I hope the postings by people in a position to know have laid to rest the guess that doctors & labs were doing the old culture test just to get more money somehow, since the old one is actually *less * expensive.
Again, I’m not a medical professional, but I’ve read in more than one place, and been told by more than one doctor that some strep throats don’t look bad at all, and that some nasty-looking throats culture negative for strep.
My experience is also that after getting a negative culture back, if the person still has a really bad sore throat, they usually test for mono. One of my kids had a throat that looked pretty bad, was negative for strep, and the blood test showed her positive for mono. Good thing we had it diagnosed or we might have handled it inappropriately. Antibiotics + strep = good result. Antibiotics + mono = bad result.