Sir.—In the PEDIATRIC FORUM of September 1986, DiNicola1 described the use of rapid group A strep throat (GAS) screening tests and observed "Not infrequently, the rapid GAS screening test was negative, with the concomitant conventional TC [throat culture] subsequently noted to be positive for GAS." DiNicola used runnystuffy nose, cough, conjunctivitis, hoarseness, and temperature over 37.8°C (100°F) as aids to determine whether to prescribe an antistrep antibiotic regardless of the result of the rapid GAS screen. If an afebrile child had two or more of these findings and a negative rapid strep screen, DiNicola did not prescribe an antibiotic. But if a child had a sore throat with or without fever and only one of the above findings and a negative rapid GAS screen, DiNicola prescribed an oral antistrep drug as soon as possible.
Is DiNicola suggesting that the more symptoms a child has with a sore throat
Preston EN. Use of Rapid Group A Strep Throat Screening Tests. Am J Dis Child. 1987;141(4):397. doi:10.1001/archpedi.1987.04460040055004