Addition of point‐of‐care test reduces antibiotic prescription in hospitalised children with suspected respiratory tract infection: A pre‐test–post‐test study

Abstract

Aim Prompt and accurate aetiological diagnostics are needed if physicians are to improve and target antibiotic treatment. We aimed to investigate whether antibiotic‐prescribing decisions are improved with availability of point‐of‐care polymerase chain reaction (POC‐PCR) diagnostic testing of children with suspected respiratory tract infection, and if it had an impact on referral for additional medical procedures. Methods This was a single‐centre one‐group pre‐test–post‐test study. Children visiting our paediatric department with respiratory tract infection symptoms were included if the treating paediatrician was considering an antibiotic prescription. Throat swabs were analysed for pathogens using POC‐PCR. The paediatrician registered treatment decisions, referrals for additional procedures and decisions about hospitalisation into a questionnaire before and after receiving the POC‐PCR results. Results We included 95 children. The availability of results from POC‐PCR analysis significantly changed the prescribed antibiotic treatment to non‐antibiotic treatment in 46% (36%–56%) of the children and the reverse in 2% (1%–8%). Paediatricians referred significantly fewer patients to additional medical procedures with availability of POC‐PCR. Conclusion POC‐PCR significantly reduced the odds of antibiotic prescription and referral for additional medical procedures. Thus, POC‐PCR presents an opportunity to improve antibiotic‐prescribing practices if it is combined with standard clinical evaluation.

Utility of Rapid Nasopharyngeal Swab for Respiratory Pathogens in the Diagnosis of Viral Infections in Children Hospitalized with Fever: A Prospective Validation Study to Improve Antibiotic Use

“…However, given what is known by historical epidemiologic data (viral infections are the commonest cause of fever in children, and bacterial-viral coinfections are relatively rare), we believe that our study further reinforces that children with positive viral swabs with a clinically coherent presentation should be considered as infected by viruses until proven otherwise. In agreement with our findings, in a recent prospective study performed in Denmark, using a point-of-care NPS test, the availability of fast results from bedside analysis significantly changed the prescribed antibiotic treatment to non-antibiotic treatment in 46% (36-56%) of the children and the reverse in 2% (1-8%) [21].…”

Clinical characteristics, factors associated with urinary tract infection and outcome in acutely admitted patients with infection; an exploratory cross-sectional cohort study

“…This rise is partly driven by inappropriate antibiotic prescription, leading to increased rates of antimicrobial resistance, an increased risk of subsequent UTI, risk of Clostridioides difficile infection, and pharmacological side effects [ [12] , [13] , [14] ]. Better diagnostic capabilities have been shown to improve antibiotic prescription in the ED, reducing antimicrobial resistance [ 15 ].…”