title: A feasibility service evaluation of screening and treatment of group A streptococcal pharyngitis in community pharmacies.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Boots UK, Nottingham NG90 1BS, UK.|School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK.
authors.forename: T
authors.initials: T
authors.lastname: Thornley
authors.affiliation: Boots UK, Nottingham NG90 1BS, UK.
authors.forename: G
authors.initials: G
authors.lastname: Marshall
authors.affiliation: Medicines Management & Pharmacy, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK.
authors.forename: P
authors.initials: P
authors.lastname: Howard
authors.affiliation: Department of Microbiology & Virology, University College London Hospitals, London W1T 4EU, UK peter.wilson@uclh.nhs.uk.
authors.forename: A P R
authors.initials: AP
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D004739:England; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010594:Pharmacies; D010612:Pharyngitis / Q000175:diagnosis* / Q000188:drug therapy*; D000067716:Point-of-Care Testing; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents