A feasibility service evaluation of screening and treatment of group A streptococcal pharyngitis in community pharmacies

J Antimicrob Chemother. 2016 Nov;71(11):3293-3299. doi: 10.1093/jac/dkw264. Epub 2016 Jul 20.

Abstract

Objectives: The UK 5 year antimicrobial resistance strategy recognizes the role of point-of-care diagnostics to identify where antimicrobials are required, as well as to assess the appropriateness of the diagnosis and treatment. A sore throat test-and-treat service was introduced in 35 community pharmacies across two localities in England during 2014-15.

Methods: Trained pharmacy staff assessed patients presenting with a sore throat using the Centor scoring system and patients meeting three or all four of the criteria were offered a throat swab test for Streptococcus pyogenes, Lancefield group A streptococci. Patients with a positive throat swab test were offered antibiotic treatment.

Results: Following screening by pharmacy staff, 149/367 (40.6%) patients were eligible for throat swab testing. Of these, only 36/149 (24.2%) were positive for group A streptococci. Antibiotics were supplied to 9.8% (n = 36/367) of all patients accessing the service. Just under half of patients that were not showing signs of a bacterial infection (60/123, 48.8%) would have gone to their general practitioner if the service had not been available.

Conclusions: This study has shown that it is feasible to deliver a community-pharmacy-based screening and treatment service using point-of-care testing. This type of service has the potential to support the antimicrobial resistance agenda by reducing unnecessary antibiotic use and inappropriate antibiotic consumption.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • England
  • Female
  • Health Services Research
  • Humans
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Pharmacies
  • Pharyngitis / diagnosis*
  • Pharyngitis / drug therapy*
  • Point-of-Care Testing*
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / drug therapy*
  • Streptococcus pyogenes / isolation & purification*
  • Young Adult

Substances

  • Anti-Bacterial Agents