Abstract
OBJECTIVE: To compare the clinical value of Group A Streptococcus (GAS) antigen detection and pathogen culture in the diagnosis and treatment of paediatric infections, providing a basis for the rational use of antibiotics. METHODS: This retrospective study included 310 paediatric patients with GAS infections admitted between January 2019 and January 2024. Patients were assigned to either the antigen-positive group (n = 156) or the culture-positive group (n = 154). Demographic characteristics, clinical features, treatment outcomes, and complications were compared between the two groups. RESULTS: There were no significant differences between the two groups in terms of demographic data (age, sex, weight) and clinical symptoms (such as fever, sore throat, and rash) (P > 0.05). The time to fever resolution (3.00 [3.00, 4.00] days vs 3.00 [2.00, 4.00] days, P = 0.103), time to sore throat resolution (3.00 [3.00, 5.00] days vs 4.00 [3.00, 5.00] days, P = 0.405), acute complication rates (6.41% vs 9.09%, P = 0.377), and late complications (none in either group) during the 3-month follow-up period showed no significant differences. CONCLUSION: GAS antigen detection and pathogen culture have comparable clinical efficacy and can both effectively guide antibiotic treatment. Rapid antigen detection can be used as the preferred screening method in clinical practice, optimising early diagnosis and treatment.