Pharmacists prescribed twice as many antibiotics during the pandemic when the requirement to test people with a sore throat prior to supply was removed, a study of a Welsh community pharmacy service has found. 

Researchers compared pre-pandemic data from the cross-Wales sore throat test and treat service (STTT) with data collected during the pandemic when remote consultations were used more and routine point-of-care testing (POCT) was not required to be carried out. 

The results, published in the Journal of Antimicrobial Chemotherapy last week (17 January 2022), showed that antibiotic supply increased by more than double: from 27% of patients under the STTT service between November 2018 and September 2019, up to 63% of patients between November 2020 and May 2021. 

The authors said: ‘These findings have implications for STTT service delivery during and beyond the Covid19 pandemic.  

‘Given the importance placed on reducing unnecessary antibiotic use as part of a multifaceted approach to combatting antimicrobial resistance, we recommend that policymakers ensure pharmacists providing STTT should do so only when diagnosis is confirmed by the use of a validated POCT,’ they suggested.   

The Welsh on-the-spot throat swab scheme aims to diagnose – through a structured clinical assessment and an antigen test – whether an illness is viral or bacterial and, if bacterial, antibiotics are prescribed by the pharmacist.  

The service was initially piloted in two health boards in Wales in 2018 before being rolled out across all boards in 2019. 

The service was paused at the beginning of the pandemic to comply with existing social distancing rules and resumed in November 2020.  

The temporary version of the service relied on remote consultations and removed the POCT requirement. Pharmacists were able to supply antibiotics to patients with sufficiently high clinical scores.  

A study conducted with GPs in 2014 similarly found that when the testing requirement for prescribing antibiotics was removed, rates of prescribing were higher. 

This comes as antimicrobial resistance is reportedly the leading cause of death worldwide. A study in The Lancet, published last week, found that antimicrobial resistance kills about 3,500 people every day. 

Over 1.2 million people died in 2019 as a result of antibiotic-resistant bacterial infections, according to the study.