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J Infect. 2019 Jun 21. pii: S0163-4453(19)30191-4. doi: 10.1016/j.jinf.2019.06.010. [Epub ahead of print]
Impact of point-of-care testing for respiratory viruses on antibiotic use in adults with exacerbation of airways disease: further analysis form a randomised controlled trial.
Brendish NJ1, Mills S2, Ewings S3, Clark TW4.
Author information
Abstract
BACKGROUND:
The ResPOC study demonstrated that syndromic molecular point-of-care testing (POCT) for respiratory viruses was associated with early discontinuation of unnecessary antibiotics compared to routine clinical care. Subgroup analysis suggests these changes occur predominantly in patients with exacerbation of airways disease. Use of molecular POCT for respiratory viruses is becoming widespread but there is a lack of evidence to inform the choice between multiplex syndromic panels versus POCT for influenza only.
MATERIALS/METHODS:
We evaluated patients from the ResPOC study with exacerbation of asthma or COPD who were treated with antibiotics. The duration of antibiotics and proportion with early discontinuation were compared between patients testing positive and negative for viruses by POCT, and controls. Patients testing positive for viruses by POCT were compared according to virus types.
RESULTS:
118 patient with exacerbation of airways disease received antibiotics in the POCT group and 111 in the control group. In the POCT group 49/118(42%) patients tested positive for viruses. Of those testing positive for viruses 17/49(35%) had early discontinuation of antibiotics versus 9/69(13%) testing negative and 7/111(6%) of controls, p<0.0001. Of those positive for viruses by POCT 10/49(20%) were positive for influenza, 21/49 43%) for rhinovirus and 18/49(37%) for other viruses. The proportion with early discontinuation of antibiotics was not different between the virus types (p=0.34).
CONCLUSIONS:
This data suggested that syndromic molecular POCT for respiratory viruses should be favoured over POCT for influenza alone in adults with exacerbation of airways disease.
Copyright ? 2019. Published by Elsevier Ltd.
KEYWORDS:
Airways disease; Antibiotic use; Hospital; Point-of-care testing; Respiratory viruses; Syndromic
PMID: 31233809 DOI: 10.1016/j.jinf.2019.06.010
Impact of point-of-care testing for respiratory viruses on antibiotic use in adults with exacerbation of airways disease: further analysis form a randomised controlled trial.
Brendish NJ1, Mills S2, Ewings S3, Clark TW4.
Author information
Abstract
BACKGROUND:
The ResPOC study demonstrated that syndromic molecular point-of-care testing (POCT) for respiratory viruses was associated with early discontinuation of unnecessary antibiotics compared to routine clinical care. Subgroup analysis suggests these changes occur predominantly in patients with exacerbation of airways disease. Use of molecular POCT for respiratory viruses is becoming widespread but there is a lack of evidence to inform the choice between multiplex syndromic panels versus POCT for influenza only.
MATERIALS/METHODS:
We evaluated patients from the ResPOC study with exacerbation of asthma or COPD who were treated with antibiotics. The duration of antibiotics and proportion with early discontinuation were compared between patients testing positive and negative for viruses by POCT, and controls. Patients testing positive for viruses by POCT were compared according to virus types.
RESULTS:
118 patient with exacerbation of airways disease received antibiotics in the POCT group and 111 in the control group. In the POCT group 49/118(42%) patients tested positive for viruses. Of those testing positive for viruses 17/49(35%) had early discontinuation of antibiotics versus 9/69(13%) testing negative and 7/111(6%) of controls, p<0.0001. Of those positive for viruses by POCT 10/49(20%) were positive for influenza, 21/49 43%) for rhinovirus and 18/49(37%) for other viruses. The proportion with early discontinuation of antibiotics was not different between the virus types (p=0.34).
CONCLUSIONS:
This data suggested that syndromic molecular POCT for respiratory viruses should be favoured over POCT for influenza alone in adults with exacerbation of airways disease.
Copyright ? 2019. Published by Elsevier Ltd.
KEYWORDS:
Airways disease; Antibiotic use; Hospital; Point-of-care testing; Respiratory viruses; Syndromic
PMID: 31233809 DOI: 10.1016/j.jinf.2019.06.010