Use of rapid diagnostic tests and choice of antibiotics in respiratory tract infections in primary healthcare—A 6-y follow-up study

Abstract

The aim of this retrospective study of electronic patient records in primary health care in Kalmar County, Sweden, was to describe consultations for respiratory tract infections (RTIs) in relation to age, choice of antibiotics and the use of rapid diagnostic tests. During the period 1999-2005, 240,445 visits for RTI were recorded. Children aged <2 y and especially those aged 2-16 y with acute otitis media (AOM), showed decreasing consultations between 2000 and 2005. The consultations for sore throat declined during the study period in all age groups and in 65% of these, antibiotics were prescribed, primarily penicillin V (82%). In sore throat, a positive Strep-A test result was followed by antibiotic prescription in about 92% of cases; when negative, the antibiotic prescription rate was 40%. C-reactive protein (CRP) was analyzed in 36% of all consultations for RTI. In common cold and acute bronchitis, the prescription rates of antibiotics rose with rising CRP. The results show that near-patient tests were used extensively, but often not in accordance with the guidelines. Antibiotic use decreased mainly as a consequence of declined visiting frequencies. This indicates that the new guidelines for AOM and sore throat may have influenced patient consultation habits more than physician prescribing habits.

Impact on antibiotic prescription of rapid antigen detection testing in acute pharyngitis in adults: a randomised clinical trial

“…In a 6-year retrospective study carried out in Sweden and published recently, negative RADT results were followed by antibiotic prescription in about 40% of cases. 6 Similar results were found in a Swiss study, which showed that as many as 75% of patients presenting a negative test outcome received antibiotics. 29 Thus, in countries in which rapid tests are still not used it is essential that all GPs are correctly informed of the benefits of this test and the low incidence of streptococcal infection in adults.…”

Antibiotics and near-patient testing: Differences in habits between physicians completing or discontinuing a medical audit

“…in clinical work, but it is very important to have strict criteria for when they should be used. A previous Swedish study indicated just like ours that there is an overuse of near-patient tests [29]. If physicians use them improperly there is a risk of overuse of antibiotics since carriers of S.p.…”

Moderate and severe pharyngitis in young adult inhabitants of Poznan, western Poland

“…a similar phenomenon was observed in some analyses from different countries (spain, sweden and Usa), although this frequency was slightly lower (30-40% of cases) [12][13][14]. This was probably due to the lack of experience in the application of radT on the part of physicians, as well as insufficient knowledge of its diagnostic accuracy [14].…”