Point-of-care-testing for respiratory viruses supports early antibiotic discontinuation

Takeaway

• Use of syndromic molecular point-of-care testing (POCT) for respiratory viruses allows early discontinuation of unnecessary antibiotics in adults presenting with exacerbation of airway disease.

Why this matters

• Consider syndromic molecular POCT over influenza-only testing for adults with acute respiratory illness to minimize unnecessary antibiotics, nosocomial transmission, and outbreaks.

Key results

• 83% (118/143) of POCT vs 79% (111/140) of control patients received antibiotics for airway disease exacerbation.
• POCT group: antibiotics had been prescribed for 79% (49/62) of patients testing positive and 85% (69/81) testing negative.
• Median turnaround time for laboratory PCR vs POCT was 31.1 vs 1.6 hours, respectively (P<.0001).
• 35% (17/49) of POCT patients testing positive for viruses discontinued antibiotics early vs 13% (9/69) of those testing negative and 6% (7/111) of control individuals (P<.0001).
  • Median antibiotic duration: 5.5 days vs 6.3 and 6.4 days.
• Proportion of early discontinuation nonreliant on virus type.

Study design

• Further analysis of ResPOC trial exploring link between POCT, changes in antibiotic use in adults presenting with exacerbations of acute respiratory disease, changes in antibiotic management because of detection of noninfluenza viruses.
• Funding: University of Southampton; NIH.

Limitations

• Single centre.
• Small sample numbers.
• Limited generalisability.