Point-of-care tests for urinary tract infections to reduce antimicrobial resistance: a systematic review and conceptual economic model

Autor: Eve Tomlinson, Mary Ward, Chris Cooper, Rachel James, Christina Stokes, Samina Begum, Jessica Watson, Alastair D Hay, Hayley E Jones, Howard Thom, Penny Whiting
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Health Technology Assessment, Vol 28, Iss 77 (2024)
Druh dokumentu: article
ISSN: 2046-4924
DOI: 10.3310/PTMV8524
Popis: Background Urinary tract infections are diagnosed by general practitioners based on symptoms, dipstick tests in some and laboratory urine culture. Patients may be given inappropriate antibiotics. Point-of-care tests can diagnose urinary tract infection in near-patient settings quicker than standard culture. Some can identify the causative pathogen or antimicrobial sensitivity. Objective To assess whether point-of-care tests for people with suspected urinary tract infection have the potential to be clinically effective and cost-effective to the NHS. Design Systematic review and conceptual economic model. Results Two randomised controlled trials evaluated Flexicult Human (one against standard care; one against ID Flexicult). One trial found no evidence of a difference between groups in concordant antibiotic use (odds ratio 0.84, 95% confidence interval 0.58 to 1.20), and the other found no difference in appropriate antibiotic prescribing (odds ratio 1.44, 95% confidence interval 1.03 to 1.99). Compared with standard care, Flexicult was associated with reduced antibiotic prescribing at initial consultation (odds ratio 0.56, 95% confidence interval 0.35 to 0.88). No difference was found for other outcomes. Sixteen studies reported test accuracy data. Most were rated as being at unclear or high risk of bias. We identified data on three rapid tests (results
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