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New test for patients with sore throats cuts antibiotic use by nearly a third
Date:11/8/2013

, in which patients were told to pick up a prescription three to five days later if their symptoms did not settle or got worse.

Patients who had four or five of the clinical features of the FeverPAIN test were prescribed antibiotics immediately; a delayed antibiotic prescription was offered to patients with two or three features and no antibiotics to those with only one or no features.

The test led to a 29 per cent reduction in antibiotic use compared with the delayed prescription approach. One in three patients in the FeverPAIN score group said their sore throat had improved rapidly from a moderately bad problem to a slight problem within two to four days. Moderately bad or worse symptoms also got better faster in the clinical score group.

However, the use of a rapid antigen test as well as the FeverPAIN test for patients who displayed streptococci symptoms did not offer any further improvements, with a 27 per cent reduction in antibiotic use as well as similar improvements in patients' symptoms.

Study co-author Dr Michael Moore, a GP and a reader in primary care research at the University of Southampton, adds: "Clinicians can consider using a clinical score to target antibiotic use for acute sore throat, which is likely to reduce antibiotic use and improve symptom control. There is no clear advantage in the additional use of a rapid antigen test.

"We found that the FeverPAIN score picks up bacterial throat infections more accurately than the current scoring system and importantly picks up larger numbers of patients who are at low risk of streptococcal infection giving the patient and the doctor the confidence not to use antibiotics. If you select those at the highest risk of streptococcal infection then antibiotics can be more targeted at the people who are most likely to get symptom benefit."


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Contact: Becky Attwood
r.attwood@soton.ac.uk
0238-059-5457
University of Southampton
Source:Eurekalert

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