No more need to go to the doctor if you suspect angina or cystitis. It will soon be possible to carry out a diagnostic test at the pharmacy and, in the process, obtain antibiotic treatment if necessary. In any case, this is one of the measures proposed in the next Social Security financing bill.
Since 2021, pharmacists can already prescribe antibiotics after rapid diagnostic orientation tests (Trod) which confirm the bacterial nature of tonsillitis and urinary infections, but only if they practice in health structures where a doctor agrees to delegate this task to them. A restriction that will soon no longer apply.
Fighting antibiotic resistance and the shortage of doctors
From 2024, all 20,000 pharmacies in France will be able to provide patients with amoxicillin, after a positive “rapid angina test”, or fosfomycin to treat occasional urinary infections (i.e. more than 80% of cystitis) ‘from a Trod. Through this extended competence, the executive seeks to fight against antibiotic resistance in a country where the consumption of antibiotics remains among the highest in Europe.
According to Health Insurance, out of six million antibiotic prescriptions for angina, only two million are justified. The device is also designed to relieve general practitioners and respond to medical deserts. The acceleration in the field of screening tests is welcomed by representatives of pharmacists who wish to go even further by advocating access to “Trod CRP”, C-reactive protein, a marker of inflammation – which can help prevent to consume antibiotics when they are not necessary.
“We deliver them every day”
For its part, the industrial sector is preparing for an increase in demand for these tests concerning angina and cystitis. “It’s starting, we’re delivering some every day. We expect an acceleration from November or December,” indicates Fabien Larue, director of AZZ, French manufacturer of Trod – which must also manage the increase in demand for Covid tests, due to the resumption of the epidemic.
At the same time, pharmacists will have to be trained: “we are in the process of sending Trods to training organizations” adds the manager who uses disabled workers to produce the tests. However, there is no question of overly complicating the lives of pharmacists, already in charge of the traditional delivery of medicines, vaccination, or even tests diagnosing flu and Covid carried out in pharmacies.
Two euros for the cystitis test, one euro for angina
Manufacturers therefore emphasize the speed and ease of execution of Trod, because “if it is not easy, pharmacists will not take advantage of it”, assures Fabien Larue. His company has thus developed a cystitis testing system that can be used “in two minutes”, “on the corner of a table or counter”. Concerning angina, the specialist is “working to improve the Trod, to do it in less than five minutes compared to 10 to 15 minutes” currently.
The majority of orders are placed by wholesalers-distributors who deliver to pharmacies in France. At two euros per Trod for cystitis, and one euro for angina, the cost seems moderate for the health system, especially since these tests “do not represent colossal volumes compared to what we have known during Covid.” However, the price of the procedure must still be fixed for pharmacists.