Respiratory virus testing shows limited impact on antibiotic prescribing in primary care
The study reports an observational analysis of 298 primary care presentations in New Zealand to evaluate how introducing respiratory virus PCR and a rapid antigen test affected patient management. Investigators found that 53% of tested patients were PCR positive, yet antibiotic prescribing remained high at 37% overall, with positive results paradoxically associated with higher antibiotic use both before and after result availability. Test results were communicated via text and email, but gaps in documentation and no measurable shift in presentation patterns were noted. The findings highlight that diagnostic testing alone does not automatically optimize antimicrobial stewardship or clinical workflows, underscoring the need for integrated clinical decision support alongside point-of-care technologies.
The original study
'No, it is a virus, your body will fight it.' The value of diagnostic testing for managing respiratory viruses in primary care: an observational study from a post-COVID pilot programme.
- Authors
- Wesley-Smith L, Dowell A, Turner N, Huang S, McIntosh C, Balm M, et al.
- Journal
- Journal of primary health care
- Type
- Journal Article
- PMID
- 42637253
Original abstract
INTRODUCTION: International studies suggest that advancing diagnostic technologies have the potential to reduce uncertainty and improve management of acute respiratory infections. AIM: This study aimed to observe the impact that laboratory-based polymerase chain reaction testing for respiratory viruses, alongside a COVID-19 rapid antigen test, had on patient management during a pandemic. Observations may enhance knowledge about the utility of respiratory virus testing in primary care. METHOD: The electronic medical records of patients tested at one urban general practice in New Zealand were examined 90 days before and after respiratory virus testing to record and analyse data on test results, patient characteristics, antibiotic prescribing, presentations, and follow-up communications. RESULTS: Among 298 presentations reviewed, 53% tested positive via polymerase chain reaction test. Antibiotics were prescribed for 37% of all presentations. Patients who tested positive for a respiratory virus were more likely to receive an antibiotic prescription than those who tested negative, both before and after test results. Notes showed texts and emails being used effectively to convey test results although some lacked evidence of test result communication. No impact on presentation patterns was identified. DISCUSSION: Test results were used for effective follow-up with some patients, but there were also gaps in communication of results and variation in prescribing patterns following receipt of test results. Test-based limitations as well as broader environmental, clinical, and psychological factors are hypothesised as influencing test use. Advancing point-of-care technologies which offer faster result availability may address some, but not all of these issues.