COVID-19 increased unnecessary antibiotic prescribing for patients with an acute sore throat

Antimicrobial resistance (AMR) has gained less attention during the COVID-19 pandemic, although its role as one of the leading global health threats has remained unchanged. Antibiotic resistance causes 1.27 million deaths per year worldwide (read more from our recent post). Antibiotic prescribing without appropriate diagnostic confirmation with diagnostic testing has increased during COVID-19.

In 2018, Wales introduced a new strategy called The Sore Throat Test and Treat (STTT), where pharmacists were allowed to manage minor illnesses and prescribe antibiotics. With patients having an acute sore throat, pharmacists made a clinical assessment and scored their symptoms. If the patient had Fever/PAIN score ≥2 and Centor score ≥3, pharmacists conducted Group A Streptococcus point-of-care test (Strep A POC test), and finally prescribed antibiotics according to the NICE guidance if patients were detected to have Streptococcus A infection.

The STTT was highly agreed upon by the pharmacists and patients. Also, GP visits and antibiotic prescribing decreased as planned. When the COVID-19 pandemic started, remote consultations began to take place in community pharmacies, and the Strep A POC testing requirement was removed. According to a recent study, antibiotic prescribing increased from the pre-pandemic period to the COVID-19 period overall by 36%. Among patients with severe symptoms, antibiotic prescribing increased by 47%. Pharmacists provided more likely antibiotics when they relied only on clinical scoring without access to the Strep A POC test.

When the COVID-19 subsides, it is crucial to take back already established healthcare strategies to improve antimicrobial stewardship. Management of acute sore throat patients by Strep A POC testing seems to have an important role in reducing unnecessary antibiotic use.

Read the original article: https://doi.org/10.1093/jac/dk...