Group A Streptococcus (GAS) Pharyngitis is the most common bacterial cause of acute Pharyngitis and is often over treated with unnecessary antibiotics. The purpose was to evaluate if implementation of a rapid antigen detection test (RADT) for GAS would reduce the number of inappropriately prescribed antibiotics for adult patients presenting with symptoms of Pharyngitis. This was a retrospective cohort study of adult urgent care clinic patients pre- and post-implementation of a GAS RADT. We included patients who had a diagnosis of GAS identified via ICD-10 codes and either a throat culture, GAS RADT, or antibiotic prescribed for GAS. Antibiotic prescribing was assessed as appropriate or inappropriate based on testing and IDSA guideline recommendations. Thirty-day follow-up visits related to Pharyngitis or the prescribed antibiotics was also evaluated. A total of 1734 patients were included; 912 and 822 in the pre- and post-implementation groups, respectively. Following implementation of the GAS RADT, there was an increase in the number of antibiotics prescribed for GAS (43.4% vs 59.1%, < .001) as well as an increase in appropriate prescribing (67.6% vs 77.5%, < .001). More 30-day Pharyngitis-related follow-up visits were seen in the pre-intervention group (12.5% vs 9.3%, = .03). Implementation of a RADT for GAS Pharyngitis was associated with an increase in both the overall number of antibiotic prescriptions for GAS and the proportion of appropriately prescribed antibiotics. There was also a reduction in follow up visits related to GAS Pharyngitis, however educational efforts to further increase appropriate prescribing is needed.
