FebriDx Point-of-Care Testing to Guide Antibiotic Therapy for AcuteRespiratory Tract Infection in UK Primary Care: A Retrospective OutcomeAnalysis

Abstract

Introduction: Acute respiratory tract infection (ARTI) is a common illness presenting to general practice in the United Kingdom. Viral and bacterial infections clinically present similarly and are frequently misdiagnosed. Diagnostic uncertainty leads to inappropriate use of antibiotic prescriptions. Objective: All patients tested with FebriDx, a new rapid diagnostic test for identifying clinically significant viral or bacterial infections, were examined to determine if test results safely impacted antibiotic prescription behaviour that would have been otherwise determined based solely on clinical signs and symptoms. Method: A retrospective chart review was performed on 21 patients that presented to an outpatient general practice with symptoms of an acute respiratory tract infection and were administered the FebriDx test. In each case, a clinical diagnosis was identified, the FebriDx test recorded, antibiotic prescriptions analysed, and the response to therapy evaluated. Results: FebriDx testing was performed on 21 patients with a mean age of 46.3 years, ranging in age from 3 years to 84 years old, including 12 males and 9 females. Patients had clinical diagnoses of both nonspecific upper respiratory tract infection (URTI) and lower respiratory tract infection (LRTI). FebriDx altered clinical management in 48% (10/21) and reduced unnecessary antibiotic prescriptions in 80% (8/10). All of the patients, inclusive of those patients given antibiotics or withheld antibiotics, demonstrated full clinical recovery without additional unscheduled medical consultations or subsequent newly initiated antibiotic prescriptions. One patient was diagnosed with bacterial sepsis and admitted to the hospital. Conclusion: Point-of-Care (POC) diagnostic testing may help primary care general practitioners cost-effectively manage patients presenting with clinical evidence of an acute febrile respiratory tract infection. FebriDx test results improved clinical management decisions and resulted in a reduction in antibiotic therapy without any subsequent adverse events.