Rapd : Rapd streptococcal antigen tests (rsat) have a sensitivity of 70-90% and a specificity of 90-100%. Thus a false positive rsat is unlikely. The major treatable bacterial pathogen is group a streptococcus which should have responded to augmentin (amoxicillin and clavulanate). Antimicrobial resistance has not been a significant issue in group a streptococcal pharyngitis. The conventional duration of oral antibiotic therapy to achieve maximal pharyngeal eradication rates is ten days, although patients usually feel better within the first several days. A follow-up evaluation should include a throat culture, because you may have non-group a beta hemolytic streptococcus. A positive throat culture will yield a sensitivity panel which should help guide therapy. It is correct that organisms present in a specimen collected from a patient with a partially treated infection may not grow on routine medium. Symptomatic relief can be often be achieved with antihistamines and decongestants that are available over the counter. I hope you feel better. If this approach also fails, i would consider other modalities, but that would involve an office visit.
Answered 10/3/2016
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