Rapid antigen detection tests (RADTs) for group A Streptococcal (GAS) infection

Recommendation for NHSScotland

A systematic review of three non-UK cluster randomised controlled trials (RCTs) reported that the use of rapid antigen detection tests (RADTs) reduces rates of antibiotic prescribing. The delayed prescribing strategy recommended as UK standard care may limit the applicability of these findings.

Based on one UK study in the context of delayed antibiotic prescribing, the use of a RADT for presence of Group A Streptococcal bacteria (GAS) in patients with acute sore throat in the general practice setting did not provide additional benefit in terms of symptom resolution or rates of antibiotic use when compared with use of a formal clinical scoring system.  In this study, use of RADTs was not cost effective.

NHSScotland is required to consider the Scottish Health Technologies Group (SHTG) advice.

What were we asked to look at?

We were asked to provide advice on the clinical and cost effectiveness of rapid antigen detection tests (RADTs) for Group A Streptococcal (GAS) infection in patients with acute sore throat in primary care, based on the published literature.

Why is this important?

Microbial resistance to antibiotics is a major public health issue. Improving the targeting of antibiotics to those patients who are most likely to benefit is one strategy for addressing this issue.

Referred by

NHS Borders and the Medicines Management Partnership