Researchers at New York University (NYU) School of Medicine set out to examine whether pediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS) were appropriately diagnosed in the community. Also, they wanted to determine subsequent rates of unwarranted use of antibiotic treatment for tics and obsessive-compulsive symptoms without the identification of an infection.

     The study involved 176 children and adolescents who were evaluated in a specialty program for tics, Tourette's disorder, and related problems. Previously published diagnostic criteria were used to establish the diagnosis of PANDAS in the NYU clinic.

     The results showed that the patients were significantly less like to receive a diagnosis of PANDAS at the NYU specialty clinic than in the community. Of the 27 subjects with a community diagnosis of PANDAS who were treated with antibiotics, 22 (82 percent) were treated without laboratory evidence of an infection; two were treated with immunomodulatory medications.

     The researchers conclude that PANDAS are frequently diagnosed in the community without the application of all working diagnostic criteria. This has resulted in unwarranted use of antibiotic treatment for tics and obsessive-compulsive disorder without evidence of laboratory infection.

 --Source: "Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcus: Comparison of Diagnosis and Treatment in the Community and at a Specialty Clinic," Pediatrics, Vol 122 #2, August 2008