Published on
Updated
Reading 2 min.
Since June 18, pharmacists can directly dispense medications in the event of a positive test for bacterial angina or cystitis under certain conditions, after the publication of a decree in the Official Journal on Tuesday. Dr Gérald Kierzek’s opinion on this development.
The first direct deliveries in pharmacies could take place “within 15 days”, the time for the first pharmacists to complete the online training necessary to be able to carry out this direct delivery, Philippe Besset, president of the FSPF, told AFP (federation of pharmacists of France).
Cystitis and tonsillitis can be treated directly in pharmacies
The decree applies a provision of the 2024 Social Security financing law. The direct delivery of antibiotics, without a medical prescription, is possible for patients over 10 years of age in the event of a positive test for bacterial angina, and for women aged 16 to 65, non-febrile, for cystitis.
- For tonsillitis, rapid oropharyngeal diagnostic tests using a long cotton swab at the back of the throat.
- For cystitis, patients will do a urine test with strips.
The pharmacist is paid 10 euros in the event of a negative test, and 15 euros in the event of a positive test. The antibiotics delivered may be amoxicillin or fosfomycin.
This direct delivery by pharmacists is part of current efforts to lighten the workload of doctors, in a context of medical desertification. The goal is to unclog doctors’ offices and speed up procedures for patients.
Dr Kierzek: “A positive device for patients but which will have to be re-evaluated”
Dr. Gérald Kierzek, medical director of Doctissimo welcomes this initiative but has some caveats: “This development is positive in the sense that it facilitates the patient journey. This is a huge time saver in cases of simple cystitis, when the doctor is not accessible. However, this implies the need to properly train pharmacists, particularly in identifying signs of seriousness…“.
Another point according to our expert: “If cystitis symptoms do not go away after receiving antibiotics, patients return to the doctor. But in this case, it is very difficult to determine the incriminated germ by a classic test (ECBU) after the use of antibiotics… This will lead to the prescription of broad-spectrum antibiotics and thus contribute to the phenomenon of resistance antibiotic. The ideal would have been to launch an ECBU from the initial delivery of antibiotics.”
In conclusion, Dr Kierzek calls for this system, which is a priori positive for patients, to be re-evaluated and even adjusted.
A global expansion of the skills of paramedical professions
Pharmacists have already recently seen their skills expanded with my ability to administer certain vaccines such as the flu and mandatory booster shots.
Other decrees moving in the direction of greater sharing of tasks with doctors are awaited by health professionals, who hope to see them appear before the legislative elections and the change of government.
Advanced practice nurses (APNs) are awaiting the decree which will allow patients to make an appointment directly with them, without a medical prescription.
This direct access, provided for by the Rist law of May 2023, will however only be possible for those working in certain collective structures such as health establishments, health centers or care homes.
Nurses are also awaiting a decree that will give them more autonomy in wound care.
Physiotherapists are hoping for the publication of a decree allowing them to experiment with direct access in 13 departments, when they are part of a CPTS (territorial professional health community), a measure promised by Prime Minister Gabriel Attal.
They are also awaiting a decree allowing them to prescribe certain health products, including some analgesics and anti-inflammatories.