Clinical Impact of a Rapid Streptococcal Antigen Test on Antibiotic Use in Adult Patients

Dodd, Melanie; Adolphe, Allen; Parada, Alisha; Brett, Meghan; Culbreath, Karissa; Mercier, Renée-Claude

doi:10.1016/j.diagmicrobio.2018.03.018

Cited by 10 publications

(11 citation statements)

References 25 publications

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“…In the adult population, a significant reduction in inappropriate antibiotic prescription (41.6% versus 11%, p < 0.0001) after the utilisation of RRP has been reported [ 45 ]. This is in line with recent literature highlighting the potential of rapid respiratory testing to increase the appropriate prescribing of antimicrobial agents [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Paediatric Antimicrobial Stewardship for Respiratory Infections in the Emergency Setting: A Systematic Review

2021

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Antimicrobial resistance occurs due to the propensity of microbial pathogens to develop resistance to antibiotics over time. Antimicrobial stewardship programs (ASPs) have been developed in response to this growing crisis, to limit unnecessary antibiotic prescription through initiatives such as education-based seminars, prescribing guidelines, and rapid respiratory pathogen (RRP) testing. Paediatric patients who present to the emergency setting with respiratory symptoms are a particularly high-risk population susceptible to inappropriate antibiotic prescribing behaviours and are therefore an ideal cohort for focused ASPs. The purpose of this systematic review was to assess the efficacy and safety of ASPs in this clinical context. A systematic search of PubMed, Medline, EMBASE and the Cochrane Database of Systematic Reviews was conducted to review the current evidence. Thirteen studies were included in the review and these studies assessed a range of stewardship interventions and outcome measures. Overall, ASPs reduced the rates of antibiotic prescription, increased the prescription of narrow-spectrum antibiotics, and shortened the duration of antibiotic therapy. Multimodal interventions that were education-based and those that used RRP testing were found to be the most effective. Whilst we found strong evidence that ASPs are effective in reducing antibiotic prescribing, further studies are required to assess whether they translate to equivalent clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Paediatric Antimicrobial Stewardship for Respiratory Infections in the Emergency Setting: A Systematic Review

2021

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“…The impact of rapid diagnostic tests on the use of antibiotics has been observed in other infectious diseases such as group A streptococcal pharyngitis, with reductions from 79% to 27% in children with pain of the throat in emergency services, 25 or from 22% to 8.3% in adults. 26 In febrile syndromes similar to dengue such as malaria, a reduction of antibiotic use from 75% to 53.6% was found after the introduction of a malaria rapid diagnostic test in rural hospitals in Uganda. 27 Hence, the various contexts in which rapid diagnostic tests contribute to the rational use of antibiotics could be further explored.…”

Section: Discussionmentioning

confidence: 99%

Impact of Dengue Rapid Diagnostic Tests on the Prescription of Antibiotics and Anti-Inflammatory Drugs by Physicians in an Endemic Area in Colombia

Tello-Cajiao

Osório

2019

The American Journal of Tropical Medicine and Hygiene

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There is insufficient evidence on whether dengue rapid diagnostic tests (dRDTs) influence clinical decisions in endemic areas. Therefore, our objective was to evaluate the impact of dRDTs on the prescription of antibiotics and antiinflammatory drugs by physicians in a dengue-endemic area in Colombia. A retrospective cohort study was conducted with 330 patients in Cali, Colombia, between January 2012 and December 2017. The exposure was defined by the result of the dRDT. The outcomes were prescription of antibiotics and anti-inflammatory drugs after results of dRDT. Incidence and RR with 95% CIs were estimated. Multivariate logistic regression models were fitted separately for each outcome. Antibiotics were prescribed in 3% exposed and 14% unexposed. Anti-inflammatory drugs were prescribed in 1.2% exposed and 7.9% unexposed. A positive dRDT reduced the prescription of anti-inflammatories (AdjOR: 0.06, 95% CI: 0.008-0.5) but, by itself, had no effect on antibiotics (AdjOR: 1.1, 95% CI: 0.2-6); however, in hospitalized patients, a positive result reduced the probability of antibiotic prescription (AdjOR: 0.02, 95% CI: 0.00-0.8). Despite limitations of current dRDTs, they influence treatment decisions. Further studies are needed to assess the effect of dRDTs in patient outcomes and health-care costs.

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“…5 For adults whose signs and symptoms do not differentiate the cause, the use of the rapid antigen detection test (RADT) for GAS pharyngitis can prevent unnecessary prescribing of antibiotics. 7 The diagnosis of GAS can be quickly established through the RADT, which involves swabbing the individual's throat. 5 The RADT has a sensitivity between 70% and 96% and specifi city between 95% and 96% in adults.…”

Section: ■ Diagnosticsmentioning

confidence: 99%

“…5,6 Adult cases are responsible for more than 7 million of those offi ce visits. 7 The fi nancial burden is substantial, with total associative costs being more than $500 million per year. 7,8 ■ Pathophysiology The nasopharynx and oropharynx constitute the fi rst line of defense for most infectious agents.…”

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confidence: 99%

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Understanding the most commonly billed diagnoses in primary care

Rogers

Eastland

2021

The Nurse Practitioner

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Clinical Impact of a Rapid Streptococcal Antigen Test on Antibiotic Use in Adult Patients

Cited by 10 publications

References 25 publications

Paediatric Antimicrobial Stewardship for Respiratory Infections in the Emergency Setting: A Systematic Review

Paediatric Antimicrobial Stewardship for Respiratory Infections in the Emergency Setting: A Systematic Review

Impact of Dengue Rapid Diagnostic Tests on the Prescription of Antibiotics and Anti-Inflammatory Drugs by Physicians in an Endemic Area in Colombia

Understanding the most commonly billed diagnoses in primary care

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