The use and usefulness of point-of-care tests in patients with pharyngotonsillitis - an observational study in primary health care

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Pallon, JonLund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Region Kronoberg (författare)

The use and usefulness of point-of-care tests in patients with pharyngotonsillitis - an observational study in primary health care

Artikel/kapitelEngelska2024

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BioMed Central (BMC),2024
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LIBRIS-ID:oai:DiVA.org:oru-110621
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-110621URI
https://doi.org/10.1186/s12875-023-02245-9DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-200507URI
https://lup.lub.lu.se/record/6ede1b90-aab2-493e-881a-0b04f4c2a20aURI

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Språk:engelska
Sammanfattning på:engelska

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Funding Agencies|Lund University
BACKGROUND: Rapid antigen detection tests (RADT) for Group A streptococci (GAS) and point-of-care tests for C-reactive protein (CRP) are commonly used in patients with pharyngotonsillitis in Sweden and Denmark although CRP testing is not supported by guidelines. We aimed to describe (1) the proportion of patients tested with RADT and/or CRP, (2) the relation between test results and antibiotic prescribing, and (3) the association between CRP level and microbial aetiology.METHODS: We used a post-hoc-analysis of data collected in primary health care in a prospective aetiological study of 220 patients 15-45 years old diagnosed with pharyngotonsillitis. The outcomes of RADTs and CRP tests were related to antibiotic prescribing and microbial aetiology.RESULTS: A RADT was used in 94% of the patients. A CRP test was used in 50% of the patients but more commonly in those with a negative RADT (59%) than in those with a positive RADT (38%) (p = 0.005). Most (74%) CRP tests were used in patients with a negative RADT. Antibiotic prescribing differed greatly between patients with a positive RADT (96%) and patients with a negative RADT (17%) (p < 0.001). In patients with a negative RADT, there was a positive association between CRP value and antibiotic prescribing (OR 1.05; 95% CI 1.02-1.07; p < 0.001). Patients with CRP values ≤ 30 mg/l were seldomly prescribed antibiotics. Patients with GAS in culture had the highest median CRP (46 mg/l), which was higher than in patients without GAS (8 mg/l; p < 0.001). However, the positive predictive value for GAS never exceeded 0.60 (95% CI 0.31-0.83) at the investigated CRP levels.CONCLUSIONS: The widespread use of tests is a major deviation from national guidelines. Most CRP tests were used in patients with a negative RADT, suggesting a belief in the added value of a CRP test, and the CRP result seemed to influence antibiotic prescribing. However, as an aetiological test, CRP is not useful for predicting GAS.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Infektionsmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Infectious Medicine hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Dermatologi och venereologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Dermatology and Venereal Diseases hsv//eng
Aetiology
Antibiotic prescribing
C-reactive protein
Pharyngotonsillitis
Primary health care
Rapid antigen detection test
Aetiology
Antibiotic prescribing
C-reactive protein
Pharyngotonsillitis
Primary health care
Rapid antigen detection test

Biuppslag (personer, institutioner, konferenser, titlar ...)

Sundqvist, Martin,1974-Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,Orebro Univ, Sweden(Swepub:lu)ma5316su (författare)
Hedin, KatarinaLinköping University,Lund University,Lunds universitet,Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Lund Univ, Sweden; Futurum, Region Jönköping County,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups(Swepub:lu)smim-khe (författare)
Allmänmedicin och samhällsmedicinForskargrupper vid Lunds universitet (creator_code:org_t)

Sammanhörande titlar

Ingår i:BMC Primary Care: BioMed Central (BMC)25:12731-4553

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Av författaren/redakt...: Pallon, Jon; Sundqvist, Marti ...; Hedin, Katarina

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Infektionsmedici ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Dermatologi och ...

Artiklar i publikationen: BMC Primary Care

Av lärosätet: Örebro universitet; Linköpings universitet; Lunds universitet

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