scholarly journals Rapid and Point-of-Care Testing in Respiratory Tract Infections: An Antibiotic Guardian?

2020 ◽  
Vol 3 (3) ◽  
pp. 401-417 ◽  
Author(s):  
Zaneeta Dhesi ◽  
Virve I. Enne ◽  
Justin O‘Grady ◽  
Vanya Gant ◽  
David M. Livermore
2020 ◽  
Vol 7 (1) ◽  
pp. e000624
Author(s):  
Jonathan Cooke ◽  
Carl Llor ◽  
Rogier Hopstaken ◽  
Matthew Dryden ◽  
Christopher Butler

Antimicrobial resistance (AMR) continues to be a global problem and continues to be addressed through national strategies to improve diagnostics, develop new antimicrobials and promote antimicrobial stewardship. Patients who attend general (ambulatory) practice with symptoms of respiratory tract infections (RTIs) are invariably assessed by some sort of clinical decision rule (CDR). However, CDRs rely on a cluster of non-specific clinical observations. A narrative review of the literature was undertaken to ascertain the value of C reactive protein (CRP) point-of-care testing (POCT) to guide antibacterial prescribing in adult patients presenting to general practitioner (GP) practices with symptoms of RTI. Studies that were included were Cochrane reviews, systematic reviews, randomised controlled trials, cluster randomised trials, controlled before and after studies, cohort studies and economic evaluations. An overwhelming number of studies demonstrated that the use of CRP tests in patients presenting with RTI symptoms reduces index antibacterial prescribing. GPs and patients report a good acceptability for a CRP POCT and economic evaluations show cost-effectiveness of CRP POCT over existing RTI management in primary care. POCTs increase diagnostic precision for GPs in the better management of patients with RTI. With the rapid development of artificial intelligence, patients will expect greater precision in diagnosing and managing their illnesses. Adopting systems that markedly reduce antibiotic consumption is a no-brainer for governments that are struggling to address the rise in AMR.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Siyuan Yang ◽  
Hui Li ◽  
Yunxia Tang ◽  
Fengting Yu ◽  
Chengjie Ma ◽  
...  

Background. The FilmArray Respiratory Panel with multiplex targets for respiratory pathogens has been widely used and verified in clinical trials in special test settings. However, it is necessary to evaluate the panel’s performance at the point of care directly, in nonspecific test settings. Methods. Patients with respiratory tract infections were enrolled from among emergency department visitors, and all steps, including the collection of specimens and testing, were performed by our clinicians. Results. Among 270 patients, 196 (72.6%) patients were found to have one or more pathogens. For signal pathogen detection, influenza A virus had the highest rate of detection; 45 (16.7%) of the patients had two or more respiratory pathogens codetected, and most of the multiplex pathogens were rhinovirus/enterovirus codetected with Bordetella pertussis (17.8%). The information provided by the FilmArray had an impact on the prescription of antimicrobials, and there were differences in the rates of antibiotic prescriptions and anti-influenza prescriptions among patients. Conclusions. Use of the FilmArray by clinical staff was successfully implemented in the emergency department for the first time in China. The FilmArray has the potential for point-of-care testing in nonspecific settings.


2016 ◽  
Vol 11 (5) ◽  
pp. 607-610 ◽  
Author(s):  
Wendy E Kaman ◽  
Gijs Elshout ◽  
Patrick JE Bindels ◽  
Konstantinos Mitsakakis ◽  
John P Hays

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