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Acute Sore Throat (Pharmacy First)

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0>=1>=10>=100–12–34–5MildSevereNoYesNoYesNOMildSevereYesNoYesNoyes
Info

Patient presenting with signs and symptoms of acute sore throat?

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Outcome

Patient is not eligible for this pathway. Refer to GP or appropriate service.

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Question

Consider the risk of deterioration or serious illness. Select ANY that apply.

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Referral

Urgent: call 999 or signpost patient to A&E immediately. Consider calculating NEWS2 Score ahead of signposting patient to A&E or calling 999 in a life-threatening emergency.

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Question

Does the patient have signs or symptoms requiring onward referral? Select ANY that apply.

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Referral

Onward referral: • General practice • Other provider as appropriate

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Question

Is the patient eligible for the Acute Sore Throat pathway? Select ANY that apply.

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Outcome

Self-care and pain relief: • Antibiotic is not needed • Offer over the counter treatment for symptomatic relief • Drink adequate fluids

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Info

Ask patient to return to Community Pharmacy after 1 week if no improvement for pharmacist reassessment.

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Outcome

Self-care and pain relief: • Antibiotics make little difference to how long symptoms last • Withholding antibiotics is unlikely to lead to complications

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Info

Ask patient to return to Community Pharmacy if no improvement within 3–5 days for pharmacist reassessment.

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Question

Shared decision making approach using TARGET RTI resources and clinician global impression. Decide symptom severity:

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Outcome

Mild symptoms: consider pain relief and self care as first line treatment. Ask patient to return if no improvement within 3–5 days.

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Info

After pharmacist reassessment (including red flags) patient can be offered antibiotics if appropriate based on clinician global impression.

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Question

Reported penicillin allergy (via National Care Record or Patient/Carer)?

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Outcome

Offer phenoxymethylpenicillin (if no allergy) for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

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Question

Is the patient pregnant?

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Outcome

Offer clarithromycin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

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Outcome

Offer erythromycin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

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Question

Returning patient for acute sore throat (after being originally advised to return if no improvement in 3-5)?

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Question

Shared decision making approach using TARGET RTI resources and clinician global impression. Decide symptom severity:

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Outcome

Mild symptoms: consider pain relief and self care as first line treatment. Ask patient to return if no improvement within 3–5 days.

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Question

Reported penicillin allergy (via National Care Record or Patient/Carer)?

allergy_check_copy_1773697996965_2 select
Outcome

Offer phenoxymethylpenicillin (if no allergy) for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

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Question

Is the patient pregnant?

pregnancy_check_copy_1773697997167_4 select
Outcome

Offer clarithromycin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

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Outcome

Offer erythromycin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

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Question

Use FeverPAIN Score to assess: 1 point for each Select ANY that apply.

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