This study aimed to link pharmacokinetic (PK) data from different flurbiprofen preparations for the treatment of sore throat with published data to elucidate whether early efficacy is due to the local action of flurbiprofen or a systemic effect after absorption of the swallowed drug. Three comparative bioavailability studies conducted in healthy subjects provided data from flurbiprofen 8.75 mg formulations, including spray solution, spray gel, lozenges, and granules. A parallel interstudy comparison was made of PK parameters, including partial AUCs (pAUCs), using an ANOVA model with the calculation of 90% confidence intervals (CI) for the differences between least squares (LS) means for each of the test groups versus the respective reference groups. All three studies showed bioequivalence for the respective product comparisons. The interstudy comparison showed a slower rate of absorption for granules compared to spray solution (reference) based on T_max, C_max, and pAUCs for 1 h and 2 h. When AUC_0.25h and AUC_0.5h were considered, slower rates of absorption were also seen for lozenges and spray gel. The differences correlated with the reported time of onset of action, which is faster for the spray solution (20 min) compared to lozenges (26 min) and granules (30 min). These pAUCs provide useful data that allow for the discrimination between formulations. Moreover, the pAUC values represent <5% of the total AUC, suggesting that the early onset of pain relief is a response to immediate local absorption at the site of action rather than a systemic effect.

Though more than 80% of acute pharyngitis (AP) cases have a viral etiology, it remains one of the most common causes for the unnecessary prescription of antibiotics (ABs). Half of patients receive antibiotics in general practice. Point-of-Care Tests (POCTs) distinguish between bacterial and viral pharyngitis. The objective of this study was to evaluate the use of POCTs using throat swabs to detect β-Streptococcus pyogenes Group A (strep A) infection among patients with sore throat/acute pharyngitis in primary care practices across Germany. A study was conducted in 1257 primary care practices. Two questionnaires were administered concerning frequency, POCT results and whether antibiotics were prescribed. Of the 1257 physicians, 60% used POCTs. Of these, 25% used a POCT before prescribing an antibiotic, 39% in cases of severe sore throat, 40% in cases of long-lasting pharyngitis and 25% in other cases. In total, 83% considered the adoption of POCTs in everyday practice to be important or very important for the diagnosis of strep A, 90% considered it important or very important for achieving a more sensible use of antibiotics and the prevention of bacterial resistance and 80% considered it important or very important for justifying to patients whether or not an antibiotic is needed. POCT results and information on AB prescriptions were available for 583 patients. Of these, 22.5% tested positive for strep A, and 21.8% were prescribed antibiotics. Our study shows that the use of swab tests in patients with sore throat in primary care practices results in high levels of physician satisfaction and can strongly reduce the misuse of antibiotics in clinical practice.

Introduction: Respiratory illness (RI) is common, and as COVID has taught us, can have a significant impact on health likely leading to changes in attitudes and behaviours. Aims and objectives: To explore how consumers currently approach the management of their most recent RI and the opportunities this presents for advice and education. Methods: Questionnaire and telephone interviews were conducted in 12 countries globally. Respondents aged 18–64 years, who had experienced and treated RI in the past 6 months were included. Results: In total, 12,000 adults completed the questionnaire (1,000 per country). The highest self-reported cause of RI was viral, namely cold, flu or COVID (64%), with headache (51%), sneezing (46%) and sore throat (44%) the symptoms most frequently cited. Most respondents had sought advice to treat their symptoms, with doctor (44%), pharmacist (39%), or family/friends (28%) ranking highest, followed by internet search (19%); 14% did not seek advice. Over half of those who sought advice were instructed to get a product from the pharmacy (52%), around a third were prescribed a treatment that was not an antibiotic (e.g. analgesics) (34%), a similar number were prescribed an antibiotic (31%), and 4% were not recommended any treatment. Almost all (99%) reported taking some form of action when unwell, including forms of self-care such as drinking fluids (41%) and using cough (37%), cold (36%) and sore throat medications (35%). Conclusions: The symptoms of RI are actively managed by consumers through self-care, advice seeking and pharmacy medications. Inappropriate antibiotic usage appears high, offering opportunities for stronger education on more suitable management.

Background: Antibiotic consumption in Italy is above the European average, as is the rate of antimicrobial resistance. In 2022, an updated national action plan was implemented to address this concern. Aims: To determine current antibiotic prescribing patterns of Italian general practitioners (GPs) for sore throat. Methods: A retrospective observational study analysed Italian primary care prescribing data between November 2018 and October 2021. The dataset from IQVIA Ltd® Longitudinal Patient Database (LPD) was filtered to identify patients with laryngitis, pharyngitis (sore throat), tonsilitis, or, glandular fever diagnosis within 14 days of an antibiotic prescription. Results: Antibiotic prescribing mirrored the seasonal trend of selected respiratory infections and was most closely associated with high-prescriber GPs. Over three years, a downward trend in patients diagnosed with sore throat was seen (reduced by 20,000 between Nov 2018 and Oct 2021). Despite a ≈49% decline in the absolute number of antibiotics prescribed to patients diagnosed with sore throat, there was a 6% increase in the proportion of antibiotics prescribed (2019 vs. 2021). Of all GPs, 24% (≈17,000) were high-prescribers, accounting for 53% of all antibiotic prescriptions, of which, 59% were to patients with sore throat (Oct 2021). The majority of second-line prescriptions were a subsequent antibiotic, including to patients with sore throat. Conclusion: Despite a decline in antibiotic prescribing, data demonstrate the ongoing use of antibiotics first-line to patients with sore throat, highlighting a need to facilitate educational campaigns and antimicrobial stewardship, possibly mostly targeting high antibiotic prescribers.