Kalmovich Boaz, Rahamim-Cohen Daniella, Shapiro Ben David Shirley
Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Biomedicines. 2023 May 22;11(5):1498. doi: 10.3390/biomedicines11051498.
Antibiotic overuse and underuse are prevalent in urgent care settings, driven in part by diagnostic uncertainty. A host-based test for distinguishing bacterial and viral infections (MeMed BV) has been clinically validated previously. Here we examined how BV impacts antibiotic prescription in a real-world setting. The intention to treat with antibiotics before the receipt of a BV result was compared with practice after the receipt of a BV result at three urgent care centers. The analysis included 152 patients, 57.9% children and 50.7% female. In total, 131 (86.2%) had a bacterial or viral BV result. Physicians were uncertain about prescription for 38 (29.0%) patients and for 30 (78.9%) of these cases, subsequently acted in accordance with the BV result. Physicians intended to prescribe antibiotics to 39 (29.8%) patients, of whom 17 (43.6%) had bacterial BV results. Among the remaining 22 patients with viral BV results, antibiotic prescriptions were reduced by 40.9%. Overall, the physician prescribed in accordance with BV results in 81.7% of all cases ( < 0.05). In total, the physicians reported that BV supported or altered their decision making in 87.0% of cases ( < 0.05). BV impacts patient management in real-world settings, supporting appropriate antibiotic use.
抗生素的过度使用和使用不足在紧急护理环境中很普遍,部分原因是诊断存在不确定性。一种用于区分细菌和病毒感染的基于宿主的检测方法(MeMed BV)此前已通过临床验证。在此,我们研究了MeMed BV在实际环境中如何影响抗生素处方。比较了在三个紧急护理中心在收到MeMed BV检测结果之前使用抗生素治疗的意向与收到检测结果后的实际做法。分析纳入了152例患者,其中57.9%为儿童,50.7%为女性。总共有131例(86.2%)患者获得了细菌或病毒的MeMed BV检测结果。医生对38例(29.0%)患者的处方存在不确定性,在这些病例中有30例(78.9%)随后根据MeMed BV检测结果采取了相应行动。医生打算给39例(29.8%)患者开抗生素,其中17例(43.6%)患者的MeMed BV检测结果为细菌感染。在其余22例MeMed BV检测结果为病毒感染的患者中,抗生素处方减少了40.9%。总体而言,在所有病例中,81.7%的医生根据MeMed BV检测结果开了药(P<0.05)。总的来说,医生报告称,在87.0%的病例中,MeMed BV检测结果支持或改变了他们的决策(P<0.05)。MeMed BV在实际环境中影响患者管理,有助于合理使用抗生素。