Anti-DNase B Strep high, but no treatment?

[JSL25]

My daughter is in a flare right now and we had some bloodwork done. Her Anti-DNase B strep levels came back above normal. Her doctor explained it to me as meaning that she was recently exposed to strep and it's still in her system. But, he won't put her on antibiotics because the strep culture was negative. Is this normal? Given that she's in a flare and showing proof of recent strep infection, should she get on antibiotics??? I'm so frustrated.

[bws1565]

How were her strep titers?  Anti DNAseB measures the antibody.

[bobh]

There is a not-so-low false negative rate with swabs and cultures.  If you do, say, 3 swabs in a row (on the same patient at about the same time) and 2 are negative and one positive, you should call it a positive, because the false negative rate is much higher than the false positive rate.  (From this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095077/  one can calculate the false negative rate as 28.1%, and the false positive rate as 5.7% - but that is just for that particular kit and the way it was used -  results for other kits and techniques can vary).