Major differences in pharmacies’ antibiotics use for sore throats highlighted
Analysis found the antibiotic supply rate from pharmacies in England was 72.7%, compared to 29.9% in Wales.
Pharmacies in England are twice as likely to prescribe antibiotics for a sore throat compared to those in Wales, according to analysis.
Researchers suggest adapting the English system to include throat swabs that confirm the presence of bacteria could reduce “unnecessary antibiotic supply”.
Academics at the London School of Hygiene and Tropical Medicine (LSHTM) and Cardiff University looked at consultations under England’s Acute Sore Throat Pharmacy First (ASTPF) and the Sore Throat Test and Treat (STTT) scheme in Wales.
Pharmacy First, which launched in England last year, allows community pharmacists to supply prescription-only medicines, including antibiotics and antivirals, without a patient seeing their GP.
The higher the score, the more likely it is that the sore throat is caused by bacteria, and patients with scores of four or five may be given antibiotics.
Meanwhile, STTT, which has been used in Wales since 2018, allows pharmacists to prescribe antibiotics with FeverPain scores of two or three if a throat swab confirms the presence of bacteria.
The analysis of the electronic pharmacy records from February to July 2024 found antibiotic supply rate was 72.7% on ASTPF and 29.9% on STTT.
First author Dr Ayodeji Matuluko, research fellow at LSHTM, said: “Our study highlights significant differences in antibiotic supply rates for sore throat between England and Wales.
“We need to collectively consider ways to ensure the appropriate use of antibiotics, to stem the potential public health threat posed by bacterial resistance.
“It’s important that we now consider what factors may be influencing this disparity, such as variation in the service provided to patients or whether there may be differences in the demographics of those who attend pharmacies with sore throats, such as age and overall health.”
“We believe that one possible reason for the difference seen in antibiotic supply rates may be the presence of a diagnostic test for patients in Wales, but this does not mean it’s the answer for pharmacies across England,” she said.
“Diagnostic tests can add additional expense to an already-burdened healthcare system and the tests themselves often vary in quality.”
The study, published in the Journal of Antimicrobial Chemotherapy, also highlights potential differences in health status and deprivation in England and Wales, as well as differences in the skills of community pharmacists.
Researchers also point out the STTT service was introduced gradually and initially piloted in 56 pharmacies, while England’s pathway was implemented nationally alongside other services.
Dr Glover added: “While these services in England and Wales are similar, they are not direct comparisons, since the data are captured differently across the two nations. IT systems, scale, pace of programme uptake and training processes are also quite different.
“Our next steps will be to investigate the uptake, antibiotic use, safety and impact of the English Pharmacy First service as a whole in much greater detail, as part of a three-year evaluation commissioned by the National Institute for Health and Care Research.”
