Programme no. 402-SY
Quality Improvement
To prescribe or not prescribe antibiotics - are rapid tests helpful?
Sigvard Mölstad*1, Morten Lindbaeck2, Lars Bjerrum3, Carl Llor4
1General practice,Institution of clinical sciences, Lund University,Malmö,Sweden, 2Primary Care,Institute of Health and Society, University of Oslo,Oslo,Norway, 3Public Health, General Practice,University of Copenhagen,Copenhagen,Denmark, 4Primary healthcare centre Jaume I,Tarragona,Spain
* = Presenting author
Objectives: To improve use of diagnostic rapid tests (POC) and antibiotic prescribing in Primary Care.
Background: Multidrug resistant bacteria are a major threat to public health. Antibiotic use and resistance are closely linked. Rapid diagnostic tests to detect Streptococcus Group A or C-reactive protein and other tests have been introduced in Primary Care to increase diagnostic accuracy and reduce unnecessary antibiotic prescribing.
Content: Current antibiotic use and resistance in different European countries will be discussed. Does prescribing in Primary Care have an impact on resistance in the community? Do we have data on resistance in the community or only reports from Microbiological laboratories? Is resistance reversibel if antibiotic prescribing is reduced, or will only patients suffer from prolonged illnesses and more complications?

The symposium will focus on rapid diagnostic tests, such as streptococcal antigen tests and C-reactive protein. These tests are not recommended in some European countries, but widely used in the Nordic countries and included in many guidelines. We will discuss the pro and cons of rapid tests. Do they improve quality of care? Are these tests really helpful to improve treatment of our patients or just a waste of time and money.

Method: The authors will show current level of resistance, use of antibiotics and of rapid tests in the different countries. We will discuss similarities and differences in use of rapid tests in relation to current evidence in the literature and hopefully agree on when rapid diagnostic tests are useful and may improve care of our patients.
Other considerations: There are many other rapid tests on the market and more are coming. Many can be bought by patients in the stoor, pharmacy or internet. All rapid tests have one thing in common, they have not been evaluated in the Primary Care setting. We should join in such studies before tests are widely used.