Point-of-care testing can support antimicrobial stewardship

A project in a Hertfordshire hospital has found that a point-of-care test (POCT) for viral respiratory infections reduced the number of inappropriate hospital admissions and antibiotic prescriptions^[1]
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Data were collected from 901 patients presenting at the emergency department with suspected viral respiratory infection. A nasal sample from each patient was prepared and analysed for viral DNA, using a machine on the ward that provided results within 45 minutes.

Overall, 507 patients (61%) tested positive for any respiratory viral infection, and 85 of these with normal C-reactive protein (CRP) levels and chest X-ray results were discharged from the emergency department. Of those patients with a positive POCT result and abnormal CRP or X-ray, 90% continued antibiotic treatment, but 52% of those with a normal CRP/X-ray result discontinued antibiotics.

Presenting their study at the European Respiratory Society’s International Congress, held in Paris from 5–19 September, 2018, the researchers concluded that POCTs could help support antimicrobial stewardship and could also prevent the cost of unnecessary hospital admissions and reduce the risk of transmitting viral infections to vulnerable individuals within hospital.

“Clinical judgement will always be required in individual patient decisions regarding antibiotic avoidance and early discharge,” the authors said.

“Integration of POCT into a multifaceted assessment tool can help to rapidly identify a lower risk cohort in which these options may be considered.”