Point-of-care tests to inform antibiotic prescribingBMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2253 (Published 21 September 2021) Cite this as: BMJ 2021;374:n2253
- Alastair D Hay, professor of primary care
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, Bristol, UK
The tests have potential but more evidence is needed
Given the global concerns about antibiotic resistance,1 antimicrobial stewardship is essential to preserve the future effectiveness of antibiotics.2 Healthcare practitioners must balance public and patient health, ensuring that only patients who need antibiotics receive them, and that they receive an antibiotic to which their infection is susceptible, at the optimum time, dose, and duration. Whether to prescribe an antibiotic is a key issue for clinicians treating respiratory infections in the community.
Point-of-care tests provide results in time to inform treatment. For respiratory infections, the tests can identify the presence of a microbe345 or measure markers of a host’s response to a microbe, such as C reactive protein or procalcitonin, in finger prick quantities of blood.
The only point-of-care tests currently recommended in the UK are urine dipstick for suspected urinary tract infections by Public Health England6 and C reactive protein for suspected pneumonia by the National Institute for Health and Care Excellence.7 Although dipstick, C reactive protein, and procalcitonin point-of-care tests are widely used internationally, the use of C reactive protein and procalcitonin remains rare in UK primary care.
Existing evidence shows that C reactive protein point-of-care …