A new, rapid microbiological point-of-care test for diagnosing respiratory infections could reduce antibiotic prescribing in primary care, according to researchers from the Centre for Academic Primary Care and the University of Bristol.
The UK government has called for the introduction of rapid diagnostics in primary care to reduce high rates of antibiotic prescribing and help combat the ongoing antimicrobial resistance (AMR) crisis.
In a study funded by the National Institute for Health Research, bioMérieux’s BioFire Filmarray v1.7 test was evaluated at four English general practice (GP) surgeries over a six-week period.
The study was done to assess the feasibility of the test’s wider use in primary care ahead of a clinical trial, to find out what clinicians thought of it and to see whether the results changed clinical decisions about diagnosis and treatment.
The test uses swabs from the nose and back of the throat to give results in around 65 minutes and can detect 17 different types of respiratory virus and three atypical respiratory bacteria.
It does not test for the most typical bacteria that cause respiratory infections because these can also live harmlessly in the nose and throat.
Of the 93 patients tested, 58% had at least one virus, 37% tested negative for any virus or bacteria, 3% had an inconclusive result and 2% had an atypical bacteria.
Before the test, clinicians prescribed antibiotics to 35% of patients who, after the test, were found to have no pathogen, and to 25% of patients who were found to have a virus.
Clinicians changed the diagnosis of one in five patients following testing and were more confident in their diagnosis after testing, especially when a virus or bacterium was detected.
During interviews, GPs and nurses said they liked the test and found it easy to use but wanted results faster and to be able to test for typical bacteria.
GPs being able to rapidly confirm the presence of infection-causing bacteria in patients with respiratory illnesses could drastically reduce the overprescribing of antibiotics, helping to ensure they are only given to those proven to need them.
Centre for Academic Primary Care professor Alastair Hay said: “Point-of-care tests for multiple 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 unnecessary antibiotic prescribing, 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 antibiotic prescribing in primary care.”
The University of Bristol specialises in research into AMR-fighting technologies, boasting a cross-faculty AMR research community known as Bristol AMR.
In 2017, the university began work on a portable and rapid antimicrobial susceptibility testing device to monitor responses of individual infection-causing bacteria to various antibiotics.