Rapid influenza tests may reduce antibiotic prescriptions, improve patient outcomes

They compared patients with acute respiratory infection (ARI) symptoms who received an RIDT and patients who did not at 2 urgent care facilities. Primary analysis using 1-to-1 exact matching resulted in 1145 matched pairs to which McNemar 2 × 2 tests were used to assess the association between the likelihood of prescribing, imaging/laboratory ordering, and RIDT use. Secondary analysis compared the same outcomes using logistic regression among the RIDT-tested population between participants who tested negative (RIDT(−)) and positive (RIDT(+)).

Results

• Primary analysis revealed that compared to the non-RIDT-tested population, RIDT(+) patients were more likely to be prescribed antivirals and less likely to be prescribed antibiotics

• Comparing RIDT-tested to non-RIDT-tested participants, RIDT use increased antiviral prescribing odds and reduced antibiotic prescribing odds

• Secondary analysis identified increased odds of prescribing antivirals and decreased odds of prescribing antibiotics for RIDT(+) participants compared with RIDT(−).

Use of rapid influenza diagnostic tests (RIDTs) in patients presenting with acute respiratory infection (ARI) symptoms influences clinician diagnostic and treatment decision-making, which could lead to improved patient outcomes, population-level reductions in influenza burden, and a decreased threat of antibiotic resistance.

Reference:

Brian D Stamm, John Tamerius, Sush Reddy, Shari Barlow, Caroline Hamer, Ashley Kempken, Maureen Goss, Cecilia He, Cristalyne Bell, Mitchell Arnold, Mary Checovich, Emily Temte, Derek Norton, Guanhua Chen, Jeffrey Baltus, Emily S Gurley, Jonathan L Temte, The Influence of Rapid Influenza Diagnostic Testing on Clinician Decision-Making for Patients With Acute Respiratory Infection in Urgent Care, Clinical Infectious Diseases, 2023;, ciad038, https://doi.org/10.1093/cid/ciad038