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Use of the FebriDx® host-response point-of-care test may reduce antibiotic use for respiratory tract infections in primary care: a mixed-methods feasibility study.

Authors :
Wilcox, Christopher R
Odeh, Nour
Clark, Tristan W
Muller, Ingrid
Becque, Taeko
Todd, Alexander
Islam, Nazrul
Little, Paul
Davies, Firoza
McGavin, John
Francis, Nick
Source :
Journal of Antimicrobial Chemotherapy (JAC); Jun2024, Vol. 79 Issue 6, p1441-1449, 9p
Publication Year :
2024

Abstract

Introduction FebriDx<superscript>®</superscript> is a CE-marked, single-use point-of-care test with markers for bacterial [C-reactive protein (CRP)] and viral [myxovirus resistance protein A (MxA)] infection, using finger-prick blood samples. Results are available after 10–12 min. We explored the usability and potential impact of FebriDx<superscript>®</superscript> in reducing antibiotic prescriptions for lower respiratory tract infection (LRTI) in primary care, and the feasibility of conducting a randomized controlled trial (RCT). Methods Patients (aged ≥1 year) with LRTI deemed likely to receive antibiotic prescription were recruited at nine general practices and underwent FebriDx<superscript>®</superscript> testing. Data collection included FebriDx<superscript>®</superscript> results, antibiotic prescribing plan (before and after testing) and re-consultation rates. Staff completed System Usability Scale questionnaires. Results From 31 January 2023 to 9 June 2023, 162 participants participated (median age 57 years), with a median symptom duration of 7 days (IQR 5–14). A valid FebriDx<superscript>®</superscript> result was obtained in 97% (157/162). Of 155 patients with available results, 103 (66%) had no detectable CRP or MxA, 28 (18%) had CRP only, 5 (3%) had MxA only, and 19 (12%) had both CRP and MxA. The clinicians' stated management plan was to prescribe antibiotics for 86% (134/155) before testing and 45% (69/155) after testing, meaning a 41% (95% CI: 31%, 51%) difference after testing, without evidence of increased re-consultation rates. Ease-of-use questionnaires showed 'good' user-friendliness. Conclusions Use of FebriDx<superscript>®</superscript> to guide antibiotic prescribing for LRTI in primary care was associated with a substantial reduction in prescribing intentions. These results support a fully powered RCT to confirm its impact and safety. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03057453
Volume :
79
Issue :
6
Database :
Complementary Index
Journal :
Journal of Antimicrobial Chemotherapy (JAC)
Publication Type :
Academic Journal
Accession number :
177611569
Full Text :
https://doi.org/10.1093/jac/dkae127