A HEALTH provider in Devon has cut antibiotic usage by nearly two-thirds by introducing point-of-care testing for patients suffering a bad sore throat.
In December, Townsend, Axminster, and Seaton & Colyton Primary Care Network began testing patients presenting with suspected a Streptococcus A (Strep A) bacterial infection.
They found that up to 65% of those who would have been ordinarily prescribed antibiotics did not actually require them.
After three months the health provider saw a 55 to 65% reduction in immediate and deferred antibiotic prescriptions when compared against standard processes for testing and care.
Current NICE guidelines recommend using a symptom scoring system to identify which patients with suspected Strep A need treatment with antibiotics.
However, point-of-care testing (POCT) in combination with these decision-making tools to support clinical assessment provides healthcare professionals with robust, evidence-based support, in the fight against antimicrobial resistance.
Dr Rob Daniels, GP at the Devon Primary Care Network and senior clinical lecturer at the University of Exeter said: "Accurately differentiating between viral and bacterial infections in a primary care setting can be challenging even for highly experienced clinicians.
“Having access to a rapid test, like Abbott’s ID NOW, which, with an accuracy greater than 90% is much more definitive than symptom scoring, helps us to avoid using antibiotics in viral sore throats and therefore target antibiotics to patients most in need.”
Antimicrobial Resistance (AMR) occurs when the microorganisms that cause disease - including bacteria, viruses, fungi and parasites - are no longer affected by antibiotics, the antimicrobial medicines used to kill them, prevent and treat the disease.
As resistance continues to increase, more people will suffer longer as infections become more difficult to treat. This results in longer hospital admissions, routine surgical procedures becoming more dangerous to perform, and higher death rates.
Seaton Pharmacy was also engaged as part of the study, which highlighted the role of community pharmacies in providing extra capacity for effective and accurate diagnosis and treatment under the Pharmacy First service.
Karen Button, the PCN manager and co-author of the paper, said: “Community pharmacy is an accessible venue for point-of-care testing, helping to support capacity within GP practices, reducing footfall in secondary care and providing patients with the right care.
"Ensuring that patients are only receiving antibiotics when they need them not only supports antimicrobial stewardship, but it also protects the antibiotic supply chain, reducing the chances of shortages.”
The findings also highlighted that nearly 90% of patients surveyed were reassured to learn the correct diagnosis during their consultation and 88% said they would like point-of-care testing to be available.
Of staff surveyed, more than 90% said testing improved treatment options and 72% would like to continue using point-of-care testing in the future.
Dr Daniels continued: “Increasing patient confidence this way is a key pillar towards improving long-term health outcomes. By establishing effective diagnostic tools within clinical practice, we can build a stronger level of trust with our patients and provide reassurance to parents and carers of children who need the right care, whilst reducing the risk of transmission."
The research and findings were led by Townsend, Axminster, and Seaton & Colyton PCN and supported by Peninsula Pathology Network, the University of Exeter and Abbott. The results of this pilot study were published in the peer-reviewed Diagnostics journal.
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