Rapid respiratory microbiological point-of-care-testing and antibiotic prescribing in primary care: Protocol for the RAPID-TEST randomised controlled trial

作者：Samantha Abbs, Lindsay Armstrong-Buisseret, Kathy Eastwood, Stephen Granier, J. Athene Lane, M. Lui, Chris Metcalfe, Paul Mitchell, Peter Muir, Matthew J Ridd, Jodi Taylor, Lucy Yardley, Grace Young, Alastair D Hay · 发表于：PLoS ONE · 年份：2024 · DOI：10.1371/journal.pone.0302302 · 被引用次数：6 · 研究领域：Antibiotic Use and Resistance、Bacterial Identification and Susceptibility Testing、Streptococcal Infections and Treatments

BACKGROUND: Antibiotics are prescribed for over 50% of respiratory tract infections in primary care, despite good evidence of there being no benefit to the patient, and evidence of over prescribing driving microbial resistance. The high treatment rates are attributed to uncertainty regarding microbiological cause and clinical prognosis. Point-of-care-tests have been proposed as potential antibiotic stewardship tools, with some providing microbiological results in 15 minutes. However, there is little research on their impact on antibiotic use and clinical outcomes in primary care. METHODS: This is a multi-centre, individually randomised controlled trial with mixed-methods investigation of microbial, behavioural and antibiotic mechanisms on outcomes in patients aged 12 months and over presenting to primary care in the UK with a suspected respiratory tract infection, where the clinician and/or patient thinks antibiotic treatment may be, or is, necessary. Once consented, all participants are asked to provide a combined nose and throat swab sample and randomised to have a rapid microbiological point-of-care-test or no point-of-care-test. For intervention patients, clinicians review the result of the test, before contacting the patient to finalise treatment. Treatment decisions are made as per usual care in control group patients. The primary outcome is whether an antibiotic is prescribed at this point. All swab samples are sent to the central laboratory for further testing. Patien...