Point-of-Care Testing for Pharyngitis in the Pharmacy

Abstract

Pharyngitis (also known as sore throat) is a common, predominately viral, self-limiting condition which can be symptomatically managed without antibiotic treatment. Inappropriate antibiotic use for pharyngitis contributes to the development and spread of antibiotic resistance. However, a small proportion of sore throats caused by group A streptococcal (GAS) infection may benefit from the provision of antibiotics. Establishing the cause of infection is therefore an important step in effective antibiotic stewardship. Point-of-care (POC) tests, where results are available within minutes, can distinguish between viral and GAS pharyngitis and can therefore guide treatment in primary healthcare settings such as community pharmacies, which are often the first point of contact with the healthcare system. In this opinion article, the evidence for the use of POC testing in the community pharmacy has been discussed. Evidence suggests that pharmacy POC testing can promote appropriate antibiotic use and reduce the need for general practitioner consultations. Challenges to implementation include cost, training and ‘who prescribes’, with country and regional differences presenting a particular issue. Despite these challenges, POC testing for pharyngitis has become widely available in pharmacies in some countries and may represent a strategy to contain antibiotic resistance and contribute to antimicrobial stewardship.

Are We Making the Most of Community Pharmacies? Implementation of Antimicrobial Stewardship Measures in Community Pharmacies: A Narrative Review

“…Such tools have been coupled with other scoring systems and further been expanded with point-of-care testing for infectious diseases [ 52 , 53 ]. Sensitivity and specificity estimates for these tests are promising, but cost-effectiveness of adopting them in a primary care setting is still debatable [ 54 ].…”

“…As described studies implicate, implementing sore throat test services in community pharmacies may reduce visits to a doctor’s office for uncomplicated sore throats [ 65 ]. Moreover, point-of-care testing promotes the choice of appropriate treatment and research shows that patients would be willing to use the service again even if they had to pay for such services [ 44 , 53 , 58 ].…”

Respiratory pathogens among ill pilgrims and the potential benefit of using point-of-care rapid molecular diagnostic tools during the Hajj

“…POC rapid molecular diagnostic tools make quick, easy-to-use testing available in patient situations where a rapid diagnosis is required, especially in the context of treating a multitude of patients with infections. In addition, the use of more sensitive and specific molecular tests promotes more appropriate antibiotic use and improves overall infection control [12,13]. Getting the appropriate antibiotics quickly, in an effective time frame, and ensuring that antibiotics are not prescribed for unnecessary conditions are key issues.…”

“…Getting the appropriate antibiotics quickly, in an effective time frame, and ensuring that antibiotics are not prescribed for unnecessary conditions are key issues. POC rapid molecular diagnostic tools have the potential to help prevent the spread of infectious diseases and impede antibiotic resistance [12,13].…”

Assessing, Pricing and Funding Point-of-Care Diagnostic Tests for Community-Acquired Acute Respiratory Tract Infections–Overview of Policies Applied in 17 European Countries

“…In light of the global health and also economic burden of AMR, point-of-care (POC) diagnostic tests can make an important contribution to improved quality of antibiotic prescribing, as they allow identifying and targeting those patients who actually need antibiotics [ 1 , 2 ]. While the value of POC tests has long been known for respiratory diseases [ 3 , 4 , 5 ], their tremendous benefit from a clinical and public health perspective was confirmed in the COVID-19 pandemic (e.g., use of polymerase chain reaction (PCR) tests) [ 6 , 7 , 8 , 9 ].…”