The RAPID-Test trial investigated whether rapid respiratory virus testing could help reduce antibiotic prescribing for patients presenting with acute respiratory tract infections in primary care settings. While researchers anticipated that the tests would support more targeted prescribing decisions, the findings told a more complex story.
Overall, the study found that rapid microbiological point-of-care testing did not reduce antibiotic prescribing. Although antibiotic use was substantially reduced among patients who tested positive for a virus, this effect was completely offset by increased prescribing in patients where no virus or atypical bacteria were detected. The study also found that use of the tests made no significant difference to patient outcomes.
The RAPID-Test trial was only possible because of earlier support from SPCR funding (Project Ref 391), which enabled the team to run a feasibility study ahead of the full randomised controlled trial. The feasibility work helped demonstrate that the research team had the processes, infrastructure, and recruitment pathways in place to successfully deliver a large-scale RCT, giving funders confidence to support the main study.
The feasibility study findings were published previously and laid the foundation for the definitive trial:
“Feasibility of a randomised controlled trial of point-of-care testing for respiratory infections in primary care”
The publication of the RAPID-Test results represents an important contribution to antimicrobial stewardship research and the ongoing evaluation of diagnostic innovations in primary care.
Further reading:
- SCPR Project 391: Novel upper respiratory tract microbiological point-of-care testing in children presenting to primary care with acute cough: A preliminary feasibility study
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Read the University of Bristol Centre for Academic Primary Care news: Study questions usefulness of rapid microbiological point-of-care respiratory test
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Read the paper: Rapid respiratory microbiological point-of-care-testing to improve antibiotic use in primary care: A randomized clinical trial by Alastair Hay et al. in JAMA Internal Medicine [open access]
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Read a linked editorial.