The recent outbreak of group A streptococcal infections in the UK1 highlights the need for accurate and prompt diagnosis of throat infections; a positive diagnosis results in at least 24 hours off work or school for patients (and their caregivers), antibiotic prescriptions for the patient and vulnerable contacts, and inevitable concern among wider contacts. This problem has been exacerbated by shortages of antibiotics. Point-of-care tests are now available that have sensitivity and specificity >90%,2 with potential to significantly improve clinical diagnosis and reduce unnecessary antibiotic prescriptions. We used the Abbott ID Now point-of-care testing system to test patients with a Centor score3 of 2 or 3, who might have received an immediate or deferred prescription: 43% of patients in this group tested negative, and therefore were not treated with antibiotics.
Although the unit cost of each test is around £20 +VAT, the wider system savings in reduced time off work or school, reduced pressure on pharmacies and antibiotic supplies, and reduced number of patients re-presenting to primary or urgent care settings should prompt discussion of the use of point-of-care testing in the proposed respiratory hubs and in routine primary care.
Notes
Competing interests
Rob Daniels works in an ENT clinic that took part in a trial of COVID-19 testing using Abbott ID Now technology, but was not paid for his part in this trial. At the beginning of the group A streptococcal pandemic his PCN received 48 free tests to try.
- © British Journal of General Practice 2023
REFERENCES
- 1.↵
- 2.↵
ID NOW™ strep A 2. ID NOW STREP A 2. Abbott.
- 3.↵
