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A new rapid point-of-care microbiological test to diagnose respiratory infections could reduce the prescription of antibiotics in primary care, according to researchers at the Center for Academic Primary Care and the University of Bristol.
The UK government has called for the introduction of rapid diagnostics into primary care to reduce high rates of antibiotic prescribing and help tackle the current crisis of antimicrobial resistance (AMR).
In a study funded by the National Institute for Health Research, bioMérieux’s BioFire Filmarray v1.7 test was evaluated in four general practice offices in English over a six-week period.
The study was carried out to assess the feasibility of wider use of the test in primary care before a clinical trial, to find out what clinicians thought about it, and to see if the results changed clinical decisions about diagnosis and the treatment.
The test uses swabs from the nose and back of the throat to give results in about 65 minutes and can detect 17 different types of respiratory viruses and three atypical respiratory bacteria.
It does not test for the most typical bacteria that cause respiratory infections, as these can also live safely in the nose and throat.
Of the 93 patients tested, 58% had at least one virus, 37% were negative for any virus or bacteria, 3% had an inconclusive result, and 2% had atypical bacteria.
Before the test, clinicians prescribed antibiotics for 35% of patients who, after testing, were found to have no pathogen, and 25% of patients who were found to carry a virus.
Clinicians changed the diagnosis of one in five patients after the test and were more confident in their diagnosis after the test, especially when a virus or bacteria was detected.
During interviews, GPs and nurses said they liked the test and found it easy to use, but wanted faster results and being able to test for typical bacteria.
The ability of general practitioners to quickly confirm the presence of bacteria responsible for infections in patients with respiratory illnesses could significantly reduce the overprescribing of antibiotics, helping to ensure that they are only given to those with proven evidence. that they need it.
Alastair Hay, professor at the Center for Academic Primary Care, said: “Point-of-care tests for several respiratory viruses and bacteria are available in the UK but mainly used in hospital settings. Our study is the first to assess the feasibility of their use in primary care. The results show the potential of these tests to improve diagnostic certainty and reduce prescriptions for unnecessary antibiotics, which is vital in the global fight against antimicrobial resistance.
“This was a small-scale feasibility study and clinical trials are now needed to see if these point-of-care tests can safely and cost-effectively reduce the prescription of antibiotics in primary care.”
The University of Bristol specializes in research into antimicrobial resistance technologies, benefiting from an interdisciplinary research community on antimicrobial resistance known as Bristol AMR.
In 2017, the university began work on a portable and rapid antimicrobial susceptibility testing device to monitor the responses of bacteria responsible for infection to various antibiotics.
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