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Point-of-care flu testing ‘increases antiviral prescribing but has no effect on antibiotics’

Point-of-care tests for influenza do not reduce antibiotic prescribing, but do increase antiviral prescribing, a new study has found.

Researchers from the University of Oxford aimed to understand if diagnostics could improve antimicrobial stewardship, but found that while point-of-care tests reduced the need for further tests, they did not reduce antibiotic prescribing.

The study, published in Clinical Infectious Diseases, analysed seven randomised and six non-randomised studies involving more than 9,000 patients, with evidence coming from both emergency departments and primary care.

Researchers found that point-of-care influenza tests did not reduce antibiotic prescribing, but were tied to a doubling of antiviral prescribing.

The paper said: ‘Point-of-care tests reduced the risk of routine blood tests by 20%, blood cultures by 18% and chest radiography by 19%.’

‘Antibiotic prescribing was not affected by testing, but antiviral prescriptions more than doubled,’ it added.

The researchers concluded: ‘There is little evidence for or against implementation in primary care. Clinicians should consider local practice before implementation.

‘Influenza point-of-care tests reduce blood tests and chest radiography, but the reduction is greatest in settings with high levels of further tests. Tests are not a substitute for clinical assessment.’

This comes after NHS England launched the new UK Antimicrobial Diagnostic Collaborative programme, which aims to get GPs to use point-of-care testing before prescribing antibiotics.

The latest figures from Public Health England found that between 2013 and 2017 overall antibiotic prescribing in primary care fell by 13.2%, attributed mainly to a 13.4% reduction in GP prescribing.

However, PHE wants to see these numbers fall further, and have pledged to cut antibiotic prescribing by a further 10% by 2020.