Date of this Version

1-1-2014

Document Type

Journal Article

Publication Details

Published Version

Little, P., Hobbs, F. D. R., Moore, M., Mant, D., Williamson, I., McNulty, C., Lasseter, G., Cheng, Y.E., Leydon, G., Leydon, G., McDermott, L., Turner, D., Pinedo-Villanueva, R., Raftery, J., Glasziou, P., & Mullee, P. (2014). PRImary care streptococcal management (PRISM) study: In vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study. Health Technology Assessment ,18(6), 1-8.

Access the journal

© Copyright, Queen's Printer and Controller of HMSO, 2014

2014 HERDC Submission

ISSN

1366-5278

Abstract

The overuse of antibiotics in primary care not only increases the risk of antibiotic resistance but exposes patients to side effects, and medicalises what are mostly self-limiting illnesses. Antibiotics are still prescribed for most patients attending primary care with acute sore throat, despite evidence from systematic reviews that there is modest benefit overall from antibiotics. Approaches to targeting antibiotics could facilitate more appropriate use of antibiotics, either targeting antibiotics using clinical scoring methods or using rapid antigen detection tests (RADTs). RADTs are very commonly used in many countries and are designed to detect the major bacterial pathogen Lancefield group A beta-haemolytic streptococcus (GABHS). However, there is debate about the importance of other major groups of streptococci (particularly Lancefield groups C and G). Furthermore, there is uncertainty about the variables that most clearly predict the presence of streptococci, and about the most appropriate RADTs to use in primary care. There is also very little robust trial evidence comparing management alternatives.

Share

COinS
 

This document has been peer reviewed.

 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.