Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health care
Background Point-of-care (POC) tests, including C-reactive protein (CRP) tests and rapid antigen detection tests (RADT) for group A streptococci (GAS), are widely used in Swedish primary health care (PHC). This study quantifies their use in pharyngotonsillitis and explore their association with anti...
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Taylor & Francis Group
2025-01-01
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| Series: | Scandinavian Journal of Primary Health Care |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02813432.2024.2416671 |
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| author | Jon Pallon Katarina Hedin |
| author_facet | Jon Pallon Katarina Hedin |
| author_sort | Jon Pallon |
| collection | DOAJ |
| description | Background Point-of-care (POC) tests, including C-reactive protein (CRP) tests and rapid antigen detection tests (RADT) for group A streptococci (GAS), are widely used in Swedish primary health care (PHC). This study quantifies their use in pharyngotonsillitis and explore their association with antibiotic prescribing.Material and methods Retrospective data from 2012–2016 in Region Kronoberg, Sweden, included all PHC visits with a pharyngotonsillitis diagnosis. Patient characteristics, test usage and antibiotic prescriptions were linked by visit date and personal identification number. Descriptive statistics were used for POC test analysis. Logistic regression assessed the association between CRP levels and antibiotic prescribing.Results Of 24,237 visits, 68% included RADT and 36% included a CRP test, with 89% of CRP tests performed alongside RADT. CRP testing was more frequent in patients with negative (56%) than positive RADTs (42%) (p < .001). Overall, 66% of RADTs were positive. Median CRP levels were 23 mg/l for positive RADT and 31 mg/l for negative RADT (p < .001). Antibiotics were prescribed for 95% of positive RADTs and 43% of negative RADTs (p < .001). In patients with negative RADTs, CRP testing was associated with higher antibiotic prescribing (57%) compared to no CRP testing (26%) (p < .001). Among these patients, CRP levels were associated with prescribing (aOR 1.032; 95% CI 1.029–1.035; p < .001), with 50% of prescriptions occuring at CRP levels ≤ 20 mg/l.Conclusion The use of RADTs and the proportion of positive test were higher than expected, indicating inappropriate use and diagnostic bias. CRP testing, contrary to guidelines, was common and associated with increased antibiotic prescribing. |
| format | Article |
| id | doaj-art-d3e1c2383ee64a41aa6a649768a0c7e5 |
| institution | Kabale University |
| issn | 0281-3432 1502-7724 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Scandinavian Journal of Primary Health Care |
| spelling | doaj-art-d3e1c2383ee64a41aa6a649768a0c7e52025-08-20T03:51:29ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242025-01-0143116417210.1080/02813432.2024.2416671Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health careJon Pallon0Katarina Hedin1Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, SwedenDepartment of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, SwedenBackground Point-of-care (POC) tests, including C-reactive protein (CRP) tests and rapid antigen detection tests (RADT) for group A streptococci (GAS), are widely used in Swedish primary health care (PHC). This study quantifies their use in pharyngotonsillitis and explore their association with antibiotic prescribing.Material and methods Retrospective data from 2012–2016 in Region Kronoberg, Sweden, included all PHC visits with a pharyngotonsillitis diagnosis. Patient characteristics, test usage and antibiotic prescriptions were linked by visit date and personal identification number. Descriptive statistics were used for POC test analysis. Logistic regression assessed the association between CRP levels and antibiotic prescribing.Results Of 24,237 visits, 68% included RADT and 36% included a CRP test, with 89% of CRP tests performed alongside RADT. CRP testing was more frequent in patients with negative (56%) than positive RADTs (42%) (p < .001). Overall, 66% of RADTs were positive. Median CRP levels were 23 mg/l for positive RADT and 31 mg/l for negative RADT (p < .001). Antibiotics were prescribed for 95% of positive RADTs and 43% of negative RADTs (p < .001). In patients with negative RADTs, CRP testing was associated with higher antibiotic prescribing (57%) compared to no CRP testing (26%) (p < .001). Among these patients, CRP levels were associated with prescribing (aOR 1.032; 95% CI 1.029–1.035; p < .001), with 50% of prescriptions occuring at CRP levels ≤ 20 mg/l.Conclusion The use of RADTs and the proportion of positive test were higher than expected, indicating inappropriate use and diagnostic bias. CRP testing, contrary to guidelines, was common and associated with increased antibiotic prescribing.https://www.tandfonline.com/doi/10.1080/02813432.2024.2416671Pharyngotonsillitisrapid antigen detection testC-reactive proteinpoint-of-care testsprimary health careantibiotic prescribing |
| spellingShingle | Jon Pallon Katarina Hedin Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health care Scandinavian Journal of Primary Health Care Pharyngotonsillitis rapid antigen detection test C-reactive protein point-of-care tests primary health care antibiotic prescribing |
| title | Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health care |
| title_full | Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health care |
| title_fullStr | Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health care |
| title_full_unstemmed | Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health care |
| title_short | Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health care |
| title_sort | use of point of care tests in pharyngotonsillitis a registry based study in primary health care |
| topic | Pharyngotonsillitis rapid antigen detection test C-reactive protein point-of-care tests primary health care antibiotic prescribing |
| url | https://www.tandfonline.com/doi/10.1080/02813432.2024.2416671 |
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