For a child suspected of having Group A strep infection, what is the next best management step?

When a child is suspected of having a Group A strep infection, the recommended management step is to perform a rapid strep test with a back-up culture if the rapid test is negative. This approach is essential for a few reasons.

The rapid strep test is a quick diagnostic tool that can provide results within minutes. It detects the presence of Group A Streptococcus in the throat, which is responsible for conditions like strep throat. Confirming the presence of this bacteria helps in accurately diagnosing the infection. However, these rapid tests can occasionally yield false negatives, which is why a back-up culture is necessary. A throat culture provides a more sensitive and definitive confirmation by allowing the bacteria to grow in a laboratory setting over a couple of days.

Initiating antibiotics immediately without confirming the diagnosis may not be the best approach, as it can lead to unnecessary medication use and contribute to antibiotic resistance. Monitoring symptoms at home could lead to delayed treatment if the infection is indeed present, increasing the risk of complications. Referral to an ENT specialist is not warranted at this stage, as the first step in management should be to confirm the diagnosis before considering specialist intervention.

Thus, performing the rapid strep test with a back-up culture is a crucial step in managing suspected