Charles Patrick G P
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia.
Curr Opin Pulm Med. 2008 May;14(3):176-82. doi: 10.1097/MCP.0b013e3282f7642f.
Respiratory tract infections are a common reason for prescribing antibiotics, although not all of these infections require such therapy. Rapid diagnosis of etiology using point-of-care tests is a potentially useful way of reducing prescriptions of both unnecessary and unnecessarily broad-spectrum antibiotics. This can also lead to the facilitation of appropriate infection control measures to prevent spread of respiratory viruses within institutions.
Point-of-care tests are available for diagnosing influenza, respiratory syncytial virus, Streptococcus pneumoniae, and Legionella infections using easily obtainable specimens. Their main benefit is that results can be obtained in about 15 min with reasonable accuracy. In many situations, however, it is still important to confirm diagnosis with more accurate but slower tests such as bacterial cultures with antibacterial susceptibility testing or viral polymerase chain reaction testing.
Although the sensitivities of many of the rapid diagnostic tests are moderate, when used at the time of initial consultation, they have the potential to reduce costs, length of stay, secondary spread of respiratory viruses, and inappropriate antibiotic prescribing.
呼吸道感染是开具抗生素的常见原因，尽管并非所有这些感染都需要此类治疗。使用即时检验进行病因的快速诊断是减少不必要和不必要的广谱抗生素处方的一种潜在有用方法。这也有助于采取适当的感染控制措施，以防止呼吸道病毒在机构内传播。
可使用易于获取的标本通过即时检验诊断流感、呼吸道合胞病毒、肺炎链球菌和军团菌感染。其主要优点是可在约15分钟内获得结果，且准确性合理。然而，在许多情况下，用更准确但耗时更长的检测方法（如进行抗菌药敏试验的细菌培养或病毒聚合酶链反应检测）来确诊仍然很重要。
尽管许多快速诊断检测的敏感性中等，但在初次会诊时使用，它们有可能降低成本、缩短住院时间、减少呼吸道病毒的二次传播以及不合理的抗生素处方。
