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Improving antibiotics targeting using PCR point-of-care testing for group A streptococci in patients with
Ronny K Gunnarsson1, Ulrich Orda2, Bradley Elliott3
1MD, PhD, Adjunct Professor, General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; General Practice/Family, Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Sweden; General Practice/Family, Centre for Antibiotic Resistance Research (CARe) at University of Gothenburg, Gothenburg, Sweden.
Background And Objectives:
Evidence supports some beneficial effects of antibiotics prescribed to patients with a sore throat and proven presence of group A streptococci (GAS).
Method:
A total of 283 patients were included from North and North-West Queensland, Australia, at their first presentation for uncomplicated acute sore throat. Patterns of antibiotic prescribing were explored before and after testing for GAS using a rapid point-of-care polymerase chain reaction (PCR) test.
Results:
The results of the study showed the Australian Therapeutic Guidelines were often not adhered to. The PCR test reduced the proportion of patients prescribed antibiotics from 46% to 40%. The decision to prescribe antibiotics was changed in 30% of patients (P <0.001): before testing only 40% of patients prescribed antibiotics had a positive GAS PCR while this increased to 97% after testing.
Discussion:
An easy-to-use point-of-care test to detect GAS allows better targeting of antibiotic prescribing in patients with an uncomplicated acute sore throat.
