Angina TRODs (rapid diagnostic orientation tests for angina) allow you to quickly determine if a sore throat is caused by a bacterial infection with group A streptococci, or not. Relatively uncomfortable, these tests involve taking a tissue sample from the throat using a swab, then exposing it to a specific solution that will determine, or not, the presence of specific bacterial antigens. They are accessible in pharmacy and as part of a medical consultation. When are they recommended? Starting at what age ? How is the collection carried out? Are they supported? Practical answers.

As indicated above, the rapid diagnostic orientation tests (TROD angina) of angina make it possible to check in a few minutes if a patient suffers from viral angina or bacterial angina (most commonly caused by group A streptococcus).

Information that makes the difference, given that bacterial angina represents nearly 30% of angina in adults, and requires the prescription of antibiotics, unlike viral angina.

As the Ministry of Health and Prevention points out, these TRODs are “essential tools in the fight against antibiotic resistance“. In fact, they make it possible to avoid the unnecessary prescription of antibiotics, which increases the resistance of certain bacteria and therefore reduces the effectiveness of these drugs.

Source: Ministry of Health and Prevention

Angina TRODs are not always essential. They are generally indicated in adults and children in case of signs suggestive of angina :

• irritation and burning in the throat,
• difficulty swallowing and severe pain,
• swollen lymph nodes,
• etc

Angina TRODs are useless before the age of three, because bacterial angina is rare in toddlers, underlines the Health Insurance. In pharmacies, however, only children over 10 years old – and adults – can benefit from such a test.

Several factors contraindicate the realization of an angina TROD:

• a known allergy to the test reagents ;
• an upper respiratory tract infection being treated with antibiotics (which may affect test results);
• a suspicion of other infectionssuch as infectious mononucleosis or diphtheria (which require different diagnosis and treatment);
• severe throat inflammation Or recent bleeding at the level of the throat, which can complicate the realization of the test.

Be that as it may, do not hesitate to consult a doctor who can best examine you before prescribing TROD.

Other factors contraindicate the test in pharmacies without a prescription:

• immunosuppression (HIV, immunosuppressive treatment, etc.);
• feverish pregnant women;
• elderly patients with temperature;
• people who have experienced similar symptoms for which they are treated with antibiotics for less than a month.

As you have probably understood, angina TRODs can be performed:

• at his doctorduring the consultation;
• or in a community pharmacy, with or without a prescription.

In detail, doctors can refer their patients to pharmacies for a TROD in the event of suspected group A streptococcal angina since December 13, 2021. They then provide a “conditional” order to patients, which authorizes the delivery of antibiotics in the event of a positive result. And, in the event of symptoms, pharmacists can also test patients without a prescription since July 1, 2021. In the event of a positive result, they must redirect patients to a doctor.

Not all pharmacies offer TROD angina. For good reason, pharmacists must meet several conditions:

• have suitable premises including a confidentiality area, accessible from the client area and with no possible access to medication;
• have suitable equipment to install patients;
• provide a water point for hand washing or a hydroalcoholic solution;
• gather the equipment necessary for carrying out the test (the TROD, a specific lamp, gloves, a stopwatch, a tongue depressor with CE marking, sampling swabs with CE marking, etc.);
• to be able to eliminate healthcare waste with infectious risks (DASRI).

Finally, professionals must have followed appropriate trainingprovided by a training organization independent of manufacturers and distributors of health products.

Angina TRODs are similar to the TRODs we experienced during the Covid-19 pandemic. Concretely, after examining the throat, doctors or pharmacists take a sample from the tonsils using a swab, a kind of long cotton swab.

The professionals then expose this sample to a liquid reagent in a tube, before dipping a strip into it. Said strip is then colored in five to ten minutes. Result ?

• If the strip displays a line: the test is negative, it is viral angina.
• If the strip displays two lines: the test is positive, it is a bacterial angina.

Note: throughout the duration of the test, the patient and doctors must respect the measures to prevent the transmission of respiratory infections, in particular the wearing a surgical mask.

The course of action depends on the situation. In the event of a positive test:

• If you have been treated by a doctor, you will get a conditional order and will have to go to a pharmacy.
• If you come to the pharmacy without a medical prescription, the pharmacist refer you to a doctor ;
• If you come to the pharmacy with a conditional prescription, the pharmacist will dispense you the prescribed antibiotics, provided that the prescription is still valid (less than 7 days).

If the test is ultimately negative, it is certainly a viral angina which must be treated appropriately.

When it is carried out at the doctor’s as part of a consultation, the angina TROD is free. But when it is made in pharmacies, it costs between 6 and 7 euros and is reimbursed up to 70% by health insurance.