A pharmacy-led sore throat test and treat (STTT) service: antigen testing and antibiotic supply rates during the period of heightened public awareness of Group A Streptococcus infections

Mantzourani, Efi ORCID: https://orcid.org/0000-0002-6313-1409, Ahmed, Haroon ORCID: https://orcid.org/0000-0002-0634-8548, Evans, Andrew, Gunnarsson, Ronny and Cannings-John, Rebecca ORCID: https://orcid.org/0000-0001-5235-6517 2024. A pharmacy-led sore throat test and treat (STTT) service: antigen testing and antibiotic supply rates during the period of heightened public awareness of Group A Streptococcus infections. Journal of Antimicrobial Chemotherapy 79 (2) , 354–359. 10.1093/jac/dkad388

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Abstract

Background Community pharmacies in Wales delivered an NHS-funded sore throat test and treat (STTT) service during the period of increased invasive Group A Streptococcus (iGAS) incidents in winter 2022–23. Service users were screened using FeverPAIN/CENTOR scores, offered GAS rapid antigen detection tests (RADT) if appropriate, and antibiotics if indicated. Objectives To evaluate the service’s response to a substantial rise in sore throat presentations during a period of heightened public anxiety. Methods Cross-sectional study with anonymized individual-level data from electronic pharmacy records of all eligible STTT service users, between January 2022 and March 2023. Results Antibiotics were supplied to 24% (95% CI: 23–24) of people who used the STTT service and 31% (95% CI: 31–32) of those who met the threshold for an RADT. Of 27 441 STTT consultations, 9308 (33.9%) occurred during December 2022. In the week commencing 2 December 2022, following the announcements of increased iGAS incidents, we observed a statistically significant increase of 1700 consultations (95% CI: 924–2476) and a statistically significant decrease in supply rate of 13.9 antibiotics per 100 RADT (95% CI: −18.40 to −9.40). Antibiotic supply rates increased thereafter to those observed before the announcements of iGAS incidents. Referral rates to other primary care or emergency settings remained below 10% throughout the study period. Conclusions Our findings suggest that, despite a dramatic increase in sore throat consultation rates in response to media reports, the pre-specified pathway followed by pharmacists ensured appropriate use of antibiotics, and absorbed a substantial workload that would otherwise end up in other healthcare settings.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Pharmacy
Publisher:	Oxford University Press
ISSN:	0305-7453
Date of First Compliant Deposit:	16 February 2024
Date of Acceptance:	29 November 2023
Last Modified:	19 Feb 2024 10:30
URI:	https://orca.cardiff.ac.uk/id/eprint/166368

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