CLIA-Waived Group a Streptococcal Pharyngitis Test and Treat Programs in Community Pharmacies

Abstract

Acute pharyngitis is mostly viral in origin, but antibiotics are commonly prescribed to cover group A streptococcus (GAS) which is the cause in 5%–30% of pharyngitis episodes. Patients are increasingly utilizing community pharmacy test and treat programs to diagnose and treat acute respiratory infections. There are several Clinical Laboratory Improvement Amendment (CLIA)-waived point-of-care tests (POCT) available to quickly identify GAS. The objective of this article is to explore the 11 antigen and two molecular CLIA-waived GAS POCTs currently available in the United States (U.S.) and the studies that assessed their use in pharmacy test and treat programs. Nine studies evaluated their use in community pharmacy test and treat programs and support their use, especially for decreasing unnecessary antibiotic prescriptions and providing access to care for patients without a primary care provider or after regular business hours. As medication dispensing margins continue to shrink, community pharmacists continue to seek additional ways to serve their patients and develop new revenue streams. Additionally, test and treat services are a means to improve access to care and promote outpatient antimicrobial stewardship. Recently, patients have expressed an increased willingness to receive care for various illnesses, including acute pharyngitis, at community pharmacies. Acute pharyngitis is well-suited for management in a community pharmacy since treatment recommendations are well established and straightforward. Overprescribing of antibiotics from traditional health care settings is higher than desired and pharmacy-based models have demonstrated the ability to decrease unwarranted antibiotic use. A pharmacy-based acute pharyngitis management model makes strong medical and business sense.