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The New Meta-Aalysis Shows Point-of-Care Testing Reduces Unnecessary Antibiotics in Patients Excerbations Exacerbations, Without Harding Outcomes.
COPD REMAINS A MAJOR PUBLIC HEALTH CONCERN, Causing Over 3 Million Deaths Globally Each Year. Acute Exacerbations of COPD (AECOPD) Frequently Prompt Clinicians to Prescription Antibiotics, Even though many exacerbations are viral rather than bacterial in origin. This Widespread and Often Precautary Antibiotic Use Contributes to Rising Antimicrobial Resistance.
Point-of-Care Testing (POCT), Including Tools Like Procalcitonin (PCT) and C-Reactive Protein (CRP), Offers Rapid Diagnostic Insight and has the potential to Guide More Judicious Antibiotic Prescription. The recent Systematic Review and Meta-Adhesis Evaluated the Effectiveness of Poct in Reducing Antibiotic Exposure in Patients with aecopd Without Commitment Clinical Safety.
Antibiotic overuse
Antibiotics are prescribed in 50–80% of aecopd Cases, but less that half of exacerbations are bacterial. Since Clinical Symptles Alone Can Be Ambiguous, Many Providers Prescription Antibiotics “Just in Case.” This practice, However, climb the Threat of Antibiotic Resistance.
“To Date, It is Still Not Clear Whether Poct Benefits aecopd Patients in Reducing Antibiotic Use and How,” wrote LIANPING YANG, PhDand colleagues in the International Journal of Infectious Diseases. “Therefore, Our Aim was to… Evaluate the Effectiveness and Safeity of Different Pocts in Guiding Antibiotic Prescription for the Treatment of Aecopd.”
For Their Systematic Review and Meta-Aalysis, Dr. Yang and Colleagues Included 18 Studies with 4,346 patients. The Analysis Focused on Randomized Controlled Trials and High-Qality Cohort Studies Comparing Poct-Guided Care to Usual Care. POCT METHODS INCUSED PCT, CRP, Molecular Diagnostics, and Neutrophil-Lymphocyte Ratio (NLR). The Primary Outcomes Were Antibiotic Prescription Rates and Clinical Outcomes, Including Hospitalization, Icu Transfer, and Mortality.
POCT REDUCES PRESCRIBING
POCT SENSENTLY REDUCED UNNECESSARY ANTIBIOTIC USE IN PATIES Excentration Exacerbations of COPD. Overall, Antibiotic Prescriptions Dropped by 16% with POCT -GUIDED CARE (Risk Difference: -0.16; 95% CI: -0.22 TO -0.10), with Procalcitonin (PCT) -Bassed Strategies Achieving The Greatest Reduction at 22%. C-Reactive Protein (CRP) and neutrophil-lymphocyte ratio (NLR) Testing also led to meaningful declines in prescription, While molecular Poct Showed Only a Modest Effect.
The average duration of antibiotic treatment was reduced by 1.19 days, with molecular poct showing the show Notable Impact, Shortening Treatment by up to 1.9 days. Importantly, these reductions in antibiotic use were not associated with any negative impact on clinical outcomes. Rates of hospitalization, adverse events, ICU Admission, Mortality, and Exacerbation Recurence Remained Comparable Between The Poct and Usual Care Groups. FURTHERMORE, POCT THAT DELIVED RESULTS IN UNDER TWO HOURS WAS LINKED TO EVEN GREATER REDUCTIONS IN ANTIBIOTIC PRESCRIBING.
The Benefits of Poct Were Consistency Across Diverse Healthcare Settings and Remained Robust In Sensitivity Analyses.
However, The Study Authors Noted That Challenges Persist. Clinician adherence to pocet guidance varied from 49% to 61%. Moreaver, Cost-Effectiveness Date Remain Limited, Special in Outpatient and Low-Resource Settings.
“Without these limitations,” The Researchers Said, “Our Findings Provide Complling Evidence Suporting The Use of Poct to Guide Antibiotic Therapy for Aecopd Without Adversse Effects on Clinical Outcomes.”
