New test for patients with sore throats cuts antibiotic use by 29%

Washington: A new 'clinical score' test for patients suffering from sore throats may help reduce the amount of antibiotics prescribed and result in patients feeling better more quickly.

Researchers at the University of Southampton, funded by the National Institute for Health Research (NIHR) Heath Technology Assessment (HTA) Programme, used the five-item FeverPAIN score to decide whether to prescribe patients with an antibiotic immediately or to give them a delayed prescription and compared it with simply offering a delayed prescription.

The FeverPAIN score includes; fever in the past 24 hours, a pus infection, rapid attendance (within three days), inflamed tonsils and no cough or cold symptoms.

Results showed that using the test reduced antibiotic use by almost 30 per cent and despite using fewer antibiotics, patients in the FeverPAIN score group experienced a greater improvement in symptoms.

Paul Little, Professor of Primary Care Research who led the research, said that the findings show that using this clinical score test can target antibiotics more effectively and help persuade patients antibiotics are not needed.

He said that the FeverPAIN score should enable better targeting of antibiotics than the current scoring system to identify the likelihood of a bacterial infection in patients complaining of a sore throat, as it allows GPs to rule out likely streptococcal infection in more patients.

The study recruited 631 patients with an acute sore throat and compared use of the FeverPAIN clinical score, with or without rapid antigen testing, with a delayed prescription, 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.

The study has been published in the British Medical Journal.

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