Hostname: page-component-84b7d79bbc-fnpn6 Total loading time: 0 Render date: 2024-07-25T16:27:46.315Z Has data issue: false hasContentIssue false

Throat swabs have no influence on the management of patients with sore throats

Published online by Cambridge University Press:  06 September 2017

L Cheung*
Affiliation:
Department of ENT, Great Western Hospitals NHS Foundation Trust, Swindon, UK
V Pattni
Affiliation:
Department of ENT, Great Western Hospitals NHS Foundation Trust, Swindon, UK
P Peacock
Affiliation:
Academy for Postgraduate Medical Education, Great Western Hospitals NHS Foundation Trust, Swindon, UK
S Sood
Affiliation:
Department of ENT, Great Western Hospitals NHS Foundation Trust, Swindon, UK
D Gupta
Affiliation:
Academy for Postgraduate Medical Education, Great Western Hospitals NHS Foundation Trust, Swindon, UK
*
Address for correspondence: Miss Linnea Cheung, Department of ENT, Great Western Hospitals NHS Foundation Trust, Marlborough Road, Swindon SN3 6BB, UK E-mail: linnea.cheung@gmail.com

Abstract

Background:

Throat swabs are neither specific nor sensitive for micro-bacteria causing sore throat symptoms; however, current guidelines suggest they are still useful in some cases.

Method:

Retrospective and prospective analyses were conducted of throat swabs requested within the months of January 2016 and August 2016, respectively.

Results:

The study comprised 247 patients. Fifty-nine (24 per cent) had a positive culture. Forty-six grew group A beta-haemolytic streptococci, with the remainder growing candida (n = 10), coliform (n = 1) and klebsiella (n = 2). There was no significant difference in culture rates between primary or secondary care sources (χ2 = 0.56, p = 0.45). None of the swabs influenced a variation in patient management from local antimicrobial policies. Current practice has an estimated annual financial impact of £3 434 340 on the National Health Service.

Conclusion:

Throat swabs do not influence the antimicrobial treatment for patients with sore throats, even under current guidelines, and incur unnecessary cost. Current clinical guidelines could be reviewed to reduce the number of throat swabs being conducted unnecessarily.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the South West Regional Audit Meeting, 13 January 2017, Exeter, UK.

References

1 Moore, M. Antibiotics: time to act. Br J Gen Pract 2013;63:340–1Google Scholar
2 Scottish Intercollegiate Guidelines Network. Management of Sore Throat and Indications for Tonsillectomy: A National Clinical Guideline. Edinburgh: Scottish Intercollegiate Guidelines Network, 2010 Google Scholar
3 National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Sore throat - acute. In: https://cks.nice.org.uk/sore-throat-acute [3 April 2017]Google Scholar
4 Little, P, Williamson, I. Sore throat management in general practice. Fam Pract 1996;13:317–21Google Scholar
5 Cooper, RJ, Hoffman, JR, Bartlett, JG, Besser, RE, Gonzales, R, Hickner, JM et al. Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann Intern Med 2001;134:509–17CrossRefGoogle ScholarPubMed
6 Fotos, PG, Vincent, SD, Hellstein, JW. Oral candidosis. Clinical, historical, and therapeutic features of 100 cases. Oral Surg Oral Med Oral Pathol 1992;74:41–9Google Scholar
7 Ghannoum, MA, Abu-Elteen, KH. Pathogenicity determinants of candida. Mycoses 1990;33:265–82CrossRefGoogle ScholarPubMed
8 Simple Statistical Software by Martin Bland. In: https:// www-users.york.ac.uk/~mb55/soft/soft.htm [20 August 2017]Google Scholar
9 Great Western Hospital Trust Prescribing Committee. ENT Guidelines for Use of Antibiotics: Trust Guideline. Swindon: Great Western Hospitals NHS Foundation Trust, 2016 Google Scholar
10 Great Western Hospital Trust Prescribing Committee. Clinical Guidelines for Use of Antibiotics in Adults with Sepsis of Unknown Origin – Non Neutropenic: Trust Guideline. Swindon: Great Western Hospitals NHS Foundation Trust, 2015 Google Scholar
11 Great Western Hospital Trust Prescribing Committee. Assessment and Treatment Guidelines for Management of Adult Patients with Neutropenic Sepsis: Trust Guideline. Swindon: Great Western Hospitals NHS Foundation Trust, 2016 Google Scholar
12 MeReC. Managing sore throats. MeReC Bulletin 1999;10:41–4Google Scholar
13 Centor, RM, Witherspoon, JM, Dalton, HP, Brody, CE, Link, K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making 1981;1:239–46CrossRefGoogle ScholarPubMed
14 Little, P, Hobbs, R, Moore, M, Mant, D, Williamson, I, McNulty, C et al. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). BMJ 2013;347:f5806 CrossRefGoogle ScholarPubMed
15 National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Candida – oral. In: https://cks.nice.org.uk/candida-oral [3 April 2017]Google Scholar
16 Brook, I, Yocum, P, Shah, K. Surface vs core-tonsillar aerobic and anaerobic flora in recurrent tonsillitis. JAMA 1980;244:1696–8Google Scholar
17 Uppal, K, Bais, AS. Tonsillar microflora--superficial surface vs deep. J Laryngol Otol 1989;103:175–7CrossRefGoogle ScholarPubMed
19 National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Scarlet fever. In: https://cks.nice.org.uk/scarlet-fever [3 April 2017]Google Scholar
20 Royal College of Paediatrics and Child Health. PHE alert on scarlet fever. In: www.rcpch.ac.uk/news/phe-alert-scarlet-fever [3 April 2017]Google Scholar
21 National Institute for Health and Care Excellence. Respiratory tract infections (self-limiting): prescribing antibiotics. Clinical guideline (CG69). In: www.nice.org.uk/guidance/CG69/ [3 April 2017]Google Scholar