Test & Treat Services

Use of this site and material contained on its pages is for EDUCATIONAL USE ONLY.

Pharmskills Online - Test & Treat Services

New Prescriptions
Rx Processing Alerts
Verification
Dispensing
RX Counseling
OTC Counseling
Clinical Services
- Perform an MTM Intervention
- Test & Treat Services
Drug Info
Other Functions
- IF-AT Exams

TEST AND TREAT PROTOCOL: Group A Streptococcal Pharyngitis - Adult

Note: this is patient variation #3.

78 bpm	Heart Rate
104/80 mmHg	Blood Pressure
97 %	O₂ Saturation
12 bpm	Respiration
100.1 °F	Temperature (oral)

First Name:		Last Name:
Date of Birth (MM/DD/YYYY):		Age:
Telephone:		Email:
Address:		City:
State:		Zip Code:
Primary Healthcare Provider:
Medication Allergies:
Current Medications:
Treatments tried for current condition:

Yes	No	Are you 18 years of age or older?
Yes	No	Are you pregnant or breastfeeding?
Yes	No	Have you ever been diagnosed with a weakened immune system (e.g., cancer, HIV/AIDS, transplant, long-term steroids, etc.)?
Yes	No	Do you have a history of rheumatic fever, rheumatic heart disease, scarlet fever, or acute GAS pharyngitis induced glomerulonephritis?
Yes	No	Do you have a history of allergic reactions to antibiotics, such as penicillin, amoxicillin, cephalexin, clarithromycin, or clindamycin?
Yes	No	Are you a resident of a nursing home or long-term care facility, in hospice, or receiving home health services?
Yes	No	Do you have a pending test for your symptoms (COVID, strep, flu)?
Yes	No	Have you had a tonsillectomy in the previous 30 days?
> 4 days ago	< 4 days ago	When did your symptoms start?
Fever:	Sore throat:	Do you have any of the following symptoms (indicate all that apply)?
Pain swallowing:	Swollen/tender lymph nodes:
Inflamed/swollen tonsils or uvula	Other

Physical Assessment (please record values)	Refer to PCP if determined clinically unstable in pharmacist professional judgment or any of the following criteria
Blood Pressure Systolic: mmHg Diastolic: mmHg	Systolic blood pressure < 90 mmHg or Diastolic blood pressure < 60 mmHg
Respiratory Rate: bpm	Respiratory rate > 30 breaths/min (single criteria); Respiratory rate > 20 breaths/min (dual criteria)
Oxygen Saturation: %	Oxygen saturation (SpO2) < 90% via pulse oximetry
Pulse: bpm	Pulse > 125 beats/min (single criteria); Pulse > 90 beats/min (dual criteria)
Temperature: °F	> 103 °F (oral), or > 102 °F (temporal), or > 104 °F (tympanic) (single criteria); < 96.8 °F (single criteria); > 100.4 °F (dual criteria)
Acute altered mental status Yes No	Yes
Severe symptoms of respiratory distress Yes No	Muffled voice; Drooling; Stridor; Respiratory distress; "Sniffing" or "tripod" positions; Fever and rigors; Severe unilateral sore throat; Bulging of the pharyngeal wall/floor or soft palate; Trismus; Crepitus; Stiff neck; or History of penetrating trauma to oropharynx.
Overt Viral Features Yes No	Conjunctivitis, rhinorrhea, cough, oral ulcers, and/or hoarseness

	S				T		C
	O
QuickVue® Strep A Test (Quidel, Lot# 572870, Exp Date: 1/9/2028)

Positive for acute GAS pharyngitis

Negative for acute GAS pharyngitis

POC Test Manufacturer:

POC Test Lot#:

POC Test Exp Date:

Acute GAS pharyngitis Diagnosed: Yes No

Antibiotic Treatment Prescribed: Yes No

Refer to PCP: Yes No

Acute GAS Pharyngitis Adult Treatment
Instructions: selection of antibiotic regimen will follow the ordered preference listed below. A lower-ranked regimen will only be prescribed if the patient or pharmacy record indicates a drug allergy or other contraindication to a higher-ranked regimen. First-line treatment Amoxicillin Contraindication: Penicillin allergy Dosing: 500 mg PO twice daily x 10 days Penicillin Contraindication: Penicillin allergy Dosing Penicillin V, oral – 500mg PO twice daily x 10 days Penicillin G benzathine – 1.2million units IM, single dose, to be administered by the pharmacist Second-line treatment Cephalexin Contraindications Cephalosporin allergy Severe penicillin allergy Dosing: 500 mg PO twice daily x 10 days Cefadroxil Contraindications Cephalosporin allergy Severe penicillin allergy Dosing: 1g PO daily x 10 days Third-line treatment Azithromycin Contraindication: Macrolide allergy Dosing: 500 mg PO once daily x 5 days Clindamycin Contraindication: Clindamycin allergy Dosing: 300 mg PO three times daily x 10 day Fourth-line treatment Clarithromycin Contraindication: Macrolide allergy Dosing: 250 mg PO twice daily x 10 days The pharmacist may recommend the following adjunctive therapy for treatment of moderate to severe symptoms or control of high fever associated with acute GAS pharyngitis, unless contraindicated Acetaminophen PO according to OTC dosing recommendations Ibuprofen PO according to OTC dosing recommendations.
Documentation of rationale for treatment selection:

Oral Amoxicillin	Dispense: 500 mg #20, no refills	Sig: i po BID x10 days
Oral Penicillin V	Dispense: 500 mg #20, no refills	Sig: i po BID x10 days
IM Penicillin G benzathine	1.2 million units IM, single dose, no refills	Sig: to be administered by the pharmacist
Oral Cephalexin	Dispense: 500 mg #20, no refills	Sig: i po BID x10 days
Oral Cefadroxil	Dispense: 1 g #10, no refills	Sig: i po QD x10 days
Oral Azithromycin	Dispense: 500 mg #5, no refills	Sig: i po QD x5 days
Oral Clindamycin	Dispense: 300 mg #30, no refills	Sig: i po TID x10 days
Oral Clarithromycin	Dispense: 250 mg #20, no refills	Sig: i po BID x10 days