Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis
Background: Challenges in identifying the causes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to overuse of antibiotics. The advantages of point-of-care testing (POCT) may help to identify pathogens and use antibiotics more appropriately. Methods: We conducted a...
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Elsevier
2025-06-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225001122 |
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| author | Xiying Li Shengyue Qiu Chaojie Liu Manzhi Zhao Xinyi Yang Haohai Xia Ruonan Wang Shanquan Chen Jie Chen Jinkun Zheng Gordon Liu Shifang Yang Lianping Yang Christopher C Butler |
| author_facet | Xiying Li Shengyue Qiu Chaojie Liu Manzhi Zhao Xinyi Yang Haohai Xia Ruonan Wang Shanquan Chen Jie Chen Jinkun Zheng Gordon Liu Shifang Yang Lianping Yang Christopher C Butler |
| author_sort | Xiying Li |
| collection | DOAJ |
| description | Background: Challenges in identifying the causes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to overuse of antibiotics. The advantages of point-of-care testing (POCT) may help to identify pathogens and use antibiotics more appropriately. Methods: We conducted a systematic review to evaluate the effect of POCT to guide antibiotic prescriptions for AECOPD. Adhering to a protocol (CRD42024555847), we searched eligible studies. The outcomes included antibiotic-related and clinical outcomes. We evaluated the risk of bias and performed meta-analyses with subgroup based on the type and testing timing of POCT. Results: A total of 18 studies evaluating 4346 AECOPD patients were included. Overall, POCT significantly reduced the number of AECOPD patients given antibiotic prescriptions by 16% (P < 0.001). Additionally, antibiotic treatment was reduced by 1.19 days (P = 0.04). There was no detrimental impact on clinical outcomes, such as the length of hospital stay (P = 0.19). Our results proved robust to sensitivity analyses. Conclusion: We offered reasonable evidence for using POCT to reduce antibiotic exposure for AECOPD without adversely affecting clinical outcomes. As diagnostic techniques become increasingly important in combating antimicrobial resistance, the use of POCT should be encouraged. |
| format | Article |
| id | doaj-art-5d705b5cce18443cbfd409b1fd4b1afb |
| institution | Kabale University |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-5d705b5cce18443cbfd409b1fd4b1afb2025-08-20T03:49:42ZengElsevierInternational Journal of Infectious Diseases1201-97122025-06-0115510788910.1016/j.ijid.2025.107889Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysisXiying Li0Shengyue Qiu1Chaojie Liu2Manzhi Zhao3Xinyi Yang4Haohai Xia5Ruonan Wang6Shanquan Chen7Jie Chen8Jinkun Zheng9Gordon Liu10Shifang Yang11Lianping Yang12Christopher C Butler13School of Public Health, Medical Division, Sun Yat-sen University, Guangzhou, ChinaSchool of Public Health, Medical Division, Sun Yat-sen University, Guangzhou, ChinaSchool of Psychology and Public Health, La Trobe University, Melbourne, AustraliaDepartment of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, ChinaSchool of Public Health, Medical Division, Sun Yat-sen University, Guangzhou, ChinaSchool of Public Health, Medical Division, Sun Yat-sen University, Guangzhou, ChinaSchool of Public Health, Medical Division, Sun Yat-sen University, Guangzhou, ChinaFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UKDepartment of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaMedical Research Center, Yuebei People's Hospital, Shaoguan, ChinaNational School of Development, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, ChinaSchool of Public Health, Medical Division, Sun Yat-sen University, Guangzhou, China; Institute for Global Health and Development, Peking University, Beijing, China; Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China; Corresponding author: Lianping Yang, School of Public Health, Medical Division, Sun Yat-sen University, No.74 Zhongshan Second Road, Yuexiu District, Guangzhou 510080, China.Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKBackground: Challenges in identifying the causes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to overuse of antibiotics. The advantages of point-of-care testing (POCT) may help to identify pathogens and use antibiotics more appropriately. Methods: We conducted a systematic review to evaluate the effect of POCT to guide antibiotic prescriptions for AECOPD. Adhering to a protocol (CRD42024555847), we searched eligible studies. The outcomes included antibiotic-related and clinical outcomes. We evaluated the risk of bias and performed meta-analyses with subgroup based on the type and testing timing of POCT. Results: A total of 18 studies evaluating 4346 AECOPD patients were included. Overall, POCT significantly reduced the number of AECOPD patients given antibiotic prescriptions by 16% (P < 0.001). Additionally, antibiotic treatment was reduced by 1.19 days (P = 0.04). There was no detrimental impact on clinical outcomes, such as the length of hospital stay (P = 0.19). Our results proved robust to sensitivity analyses. Conclusion: We offered reasonable evidence for using POCT to reduce antibiotic exposure for AECOPD without adversely affecting clinical outcomes. As diagnostic techniques become increasingly important in combating antimicrobial resistance, the use of POCT should be encouraged.http://www.sciencedirect.com/science/article/pii/S1201971225001122Acute exacerbations of COPDAntibioticsProcalcitoninC-reactive proteinPoint-of-care testing |
| spellingShingle | Xiying Li Shengyue Qiu Chaojie Liu Manzhi Zhao Xinyi Yang Haohai Xia Ruonan Wang Shanquan Chen Jie Chen Jinkun Zheng Gordon Liu Shifang Yang Lianping Yang Christopher C Butler Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis International Journal of Infectious Diseases Acute exacerbations of COPD Antibiotics Procalcitonin C-reactive protein Point-of-care testing |
| title | Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis |
| title_full | Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis |
| title_fullStr | Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis |
| title_full_unstemmed | Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis |
| title_short | Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis |
| title_sort | point of care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease a systematic review and meta analysis |
| topic | Acute exacerbations of COPD Antibiotics Procalcitonin C-reactive protein Point-of-care testing |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225001122 |
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