Outpatient Antibiotic Stewardship: A Growing Frontier—Combining Myxovirus Resistance Protein A With Other Biomarkers to Improve Antibiotic Use

Joseph, Patrick; Godofsky, Eliot

Differentiation of infection from colonization requires the demonstration of an antibody response. However, proving this immune response is time-consuming and may lead to false-negative results following appropriate antibiotic therapy [23] . A study by Ivaska et al. [3] showed that in 83 patients presenting with pharyngitis, there was no significant difference in the mean initial serum antistreptolysin O (ASO) levels between the GABHS and non-GABHS patients and only 5 patients showed a 2-fold ASO increase in paired serum samples. Of the 5 patients with an antibody response, 3 of them were GABHS positive, 1 of them was GCBHS positive, and 1 was negative for streptococci by throat culture. Conversely, blood MxA levels were found to be elevated in 79% of patients with viral pharyngitis and remained low in 90% of patients with GABHS without virus detection [3] .