Background: Acute pharyngitis is a common reason for consultation in otorhinolaryngology. Distinguishing viral from bacterial etiologies, particularly group A streptococcal (GAS) infection, is essential to reduce inappropriate antibiotic prescribing, especially in low-resource settings where rapid antigen detection testing (RADT) is not widely implemented. Objective: To assess the value of RADT in the management of acute pharyngitis at the Renaissance University Hospital Center in N’Djamena, Chad. Methods: We conducted a descriptive cross-sectional study with prospective data collection over 18 months. Patients aged ≥3 years presenting with acute pharyngitis were included. All underwent clinical examination with McIsaac score calculation. RADT was performed systematically in children aged 3 - 15 years and in adolescents/adults (≥16 years) when the McIsaac score was ≥3. Data were analyzed using SPSS version 26.0. Results: A total of 136 patients were included (mean age 19.8 ± 13.2 years; male-to-female ratio 0.92). RADT was performed in 91/136 patients (66.9%), including all children and only adolescents/adults with a McIsaac score ≥ 3. Among this selected subgroup, RADT was positive in 65/91 cases (71.4%). RADT positivity was significantly associated with the McIsaac score (p < 0.05). All RADT-positive patients received antibiotics, whereas most RADT-negative patients did not; RADT result was strongly associated with antibiotic prescribing (Fisher’s exact test, p < 0.001). Conclusion: Rapid antigen testing appears to be a useful tool for guiding antibiotic prescription in acute pharyngitis, particularly in resource-limited settings, by reducing unnecessary antibiotic use.
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