To swab or not to swab? Using point-of-care tests to detect Group A Streptococcus infections as part of a Sore Throat Test and Treat service in community pharmacy

Mantzourani, Efi ORCID: https://orcid.org/0000-0002-6313-1409, Cannings-John, Rebecca ORCID: https://orcid.org/0000-0001-5235-6517, Evans, Andrew and Ahmed, Haroon ORCID: https://orcid.org/0000-0002-0634-8548 2022. To swab or not to swab? Using point-of-care tests to detect Group A Streptococcus infections as part of a Sore Throat Test and Treat service in community pharmacy. Journal of Antimicrobial Chemotherapy 10.1093/jac/dkab470

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Abstract

Background The community pharmacy-led Sore Throat Test and Treat (STTT) service in Wales allowed pharmacists to undertake a structured clinical assessment with FeverPAIN/Centor scores and a point-of-care test (POCT) for Group A Streptococcus (GAS) infection. A new service model was temporarily agreed as a result of COVID-19, without routine use of POCT. Objectives To explore the impact of removing the requirement for GAS POCT from a community pharmacy STTT service on antibiotic supply. Methods Analysis of STTT consultation data, obtained for two periods: November 2018 (date the service went live) to September 2019 (pre-pandemic); and November 2020 (date the new service model was introduced) to May 2021. Results For consultations eligible for POCT, the antibiotic supply rate increased from 27% (922/3369) (95% CI: 26%–29%) with the pre-pandemic service model (FeverPAIN/Centor + POCT) to 63% (93/147) (95% CI: 55%–71%) with the new model (FeverPAIN/Centor only); the percentage of patients who were not issued an antibiotic, despite their high clinical score, decreased from 56% (646/1154) to 9.3% (8/86). Conclusions Preliminary data suggest that for every 100 STTT consultations with patients with a Centor score of ≥3 or a FeverPAIN score of ≥2, the use of POCT may spare up to 36 courses of antibiotics, increasing to 47 for patients with higher clinical scores, suggesting that the pre-COVID delivery model (FeverPAIN/Centor + POCT) is the optimal pathway and POCT in addition to clinical scores may result in fewer antibiotic prescriptions for sore throat symptoms. These findings have implications for STTT service delivery during and beyond the COVID-19 pandemic.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Pharmacy Centre for Trials Research (CNTRR)
Additional Information:	This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, providedthe original work is properly cited.
Publisher:	Oxford University Press
ISSN:	0305-7453
Date of First Compliant Deposit:	15 February 2022
Date of Acceptance:	12 November 2021
Last Modified:	22 May 2023 15:04
URI:	https://orca.cardiff.ac.uk/id/eprint/147483

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