Rapid strep tests now available at some Nova Scotia pharmacies

A rapid strep test is now being offered by some pharmacies and doctors in Nova Scotia, which means you no longer need to wait 48 hours for test results to find out if you have strep throat.

"It certainly seems to be safe [and] seems to be reliable," said Dr. Howard Conter, a family physician in Halifax who uses the rapid tests in his clinic's lab and at a summer camp for young people.

Conter said it's good to back up the rapid test by using a traditional throat swab when possible, but it takes at least 48 hours before swab results come back from the lab. Most of the time, Conter said he's comfortable starting the patient on antibiotics based on the rapid test.

"Essentially, I think the word rapid is the key," he said. "Within four or five minutes you can have an answer as to whether or not that throat infection is viral or bacterial, so if strep is positive you know you have a strep throat."

Pharmacy pilots test

Shoppers Drug Mart in Nova Scotia has started a pilot with the rapid strep tests. For $15, a trained pharmacist will administer the test. 

A throat swab is taken and then tested on-site for a substance specific to the bacteria that causes strep throat, according to the pharmacy's website. The rapid test means the swab does not have to be sent to a lab and grown in a culture.

Pharmacists are not able to prescribe antibiotics, so people who test positive must still see their doctor or nurse practitioner.

Conter said that's important because medical professionals look at the big picture.

"There's concern about other medications the patient might be on, there's concern about other symptoms they might have," he said.

"Strep can be a very serious disease if a patient has a history of stroke or heart attack or valve problems in the heart — so there's a lot of history-taking and understanding of a patient's overall well-being outside of just the strep infection."

Tammy Smitham, a spokeswoman for Shoppers Drug Mart, told CBC News the pilot was reviewed with Doctors Nova Scotia before it started, and patients who use the test will be surveyed.

"We feel that this may help to reduce antibiotic resistance problems that could occur if patients get a prescribed antibiotic without first confirming if they have strep," said Smitham.

The Pharmacy Association of Nova Scotia said there are several rapid strep tests on the market. Sandeep SodhI, the chair of the board, said while the association doesn't know which test Shoppers Drug Mart is using, "we believe any program that supports the reduction of antibiotic resistance is a good thing for our patients."

Tests not foolproof

The Nova Scotia Health Authority does use rapid strep tests, but the reliability depends on the age group being tested, according to Dr. Todd Hatchett, division head and service chief for microbiology for the health authority's central division.

"In children we know that strep is much more common, so the test performs better in kids than it does in adults," he said. "In adults, you're more likely to get a false-negative test because sensitivity of these tests is less than for culture."

Hatchett said the central zone does use the tests to diagnose children, but generally uses lab cultures to diagnose strep in adults rather than the rapid kits.

"In a physician's office, if an adult is thought to have a strep infection and they have a negative rapid test, then we recommend they send in the swab for culture."

He said the health authority has no jurisdiction over how pharmacies use the test but it is now looking to develop provincial guidelines and standards for its use of the so-called point-of-care tests.

"Where these tests are helpful is if they're positive, because if they're positive and you have the right symptoms it's most likely a good indication that you truly have a strep infection and antibiotics are necessary," Hatchett said.

"If they're negative, because the sensitivity is not 100 per cent, you can't really rule out strep infection so you need to do a culture if you have a strong suspicion the symptoms are due to strep infection."