Impact of rapid diagnostic testing for chlamydia and gonorrhea on appropriate antimicrobial utilization in the emergency department

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Abstract

Prolonged turnaround time of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) test results may delay time to notification and treatment of test-positive patients and result in unnecessary antimicrobial use in test-negative patients. This quasi‐experimental study evaluated the impact of NG/CT rapid diagnostic testing (RDT) in an urban emergency department (ED) on treatment appropriateness, time to notification, and cost. Patients tested in December 2013–January 2014 (traditional group, n = 200) were compared with those in December 2014–January 2015 (RDT group, n = 200). There was a significant increase in treatment appropriateness in the RDT group, 72.5% versus 60% (P = 0.008) and time to results notification was significantly faster (median 17.4 versus 51.5 hours, P = 0.010). Availability of test result prior to discharge was associated with increased treatment appropriateness (odds ratio, 22.65 [95% confidence interval, 2.86–179.68]). The RDT would save approximately $37,000 annually. These results support the use of NG/CT RDT to expand antimicrobial stewardship efforts within the ED.

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Rivard, K. R., Dumkow, L. E., Draper, H. M., Brandt, K. L., Whalen, D. W., & Egwuatu, N. E. (2017). Impact of rapid diagnostic testing for chlamydia and gonorrhea on appropriate antimicrobial utilization in the emergency department. Diagnostic Microbiology and Infectious Disease, 87(2), 175–179. https://doi.org/10.1016/j.diagmicrobio.2016.10.019

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