A novel service to target appropriate antimicrobial prescription and improve antibiotic stewardship shows potential, according to a study recently presented at the European Respiratory Society International Congress 2018, held September 15 to 19 in Paris, France.
Respiratory infections comprise a significant proportion of acute admissions. In developed countries, acute respiratory infections are the cause for the majority of prescriptions for antibiotics, 20% of all medical consultations, and more than 30% of lost days from work. Using point-of-care testing for respiratory viruses allows for rapid diagnosis, which could help influence initial treatment decisions, reduce antibiotic-associated morbidity, and facilitate early discharge. Therefore, this study aimed to determine whether rapid diagnosis of respiratory viruses can optimize antibiotic prescribing and/or prevent admission in patients presenting acutely with infective respiratory symptoms.
This study used a service-oriented respiratory viral point-of-care-testing service (BioFire) in the United Kingdom. This service provides results from nasopharyngeal swabs within 45 minutes that are intended to be used in the emergency department. Using this service, a total of 130 patients who presented acutely with infective respiratory symptoms were included and tested.
Of these patients, 84 tested positive for viruses, including: influenza (n=57), rhinovirus (n=12), coronavirus (n=7), metapneumothovirus (n=5), respiratory syncytial virus (n=2), and adenovirus (n=1). No clinical indication of antibiotics was determined for 47 patients who had tested positive and had a normal chest radiograph. Further, 22 of these 47 patients were inappropriately prescribed antibiotics; the remaining 25 patients were discharged safely without readmission.
Overall, the study authors concluded that, “Initial results show potential of this service to inform clinicians to stop antibiotics confidently and avoid admission in a significant number of cases of respiratory viral infection where there is no evidence of bacterial infection.”
Roy K, Groom K, Kandil H, Knight M. Point of care respiratory viral testing (POCT): a novel service to target appropriate antimicrobial prescription and improve antibiotic stewardship. Presented at: European Respiratory Society International Congress 2018; September 15-19, 2018; Paris, France. Abstract PA2032.