Clinical Decision Rule of Steinhoff et al for Management of Streptococcal Pharyngitis in a Low-Resource Setting

Patient selection: children 2-12 years old with sore throat in a setting with limited resources

Parameters for the 3-item score (each scored 1 point if present, 0 if absent):

(1) tender or enlarged anterior cervical lymph nodes

(2) absence of rhinitis

(3) absence of skin rash

Additional factors seen with streptococcal pharyngitis:

(1) pharyngeal exudate

(2) presentation during a season with higher rate (dry season of the year in Egypt)

(3) absence of cough

Performance of 3-item rule:

• For a cut-off of >= 2 the sensitivity is 92% and specificity 38%.

• Use of the rule would reduce antibiotic use in group A beta-hemolytic streptococcal negative patients by about 40%.