New uni trial to test if infections need antibiotics

RAPID tests to check whether infections are caused by bacteria or viruses – and whether they need antibiotics – are to be trialled in GP surgeries across the West.

The trial, led by the University of Bristol, will investigate whether testing patients at the point they turn up with symptoms of a respiratory infection could cut the number of antibiotic prescriptions given out.

The swab tests can detect multiple viruses and some bacteria, with results available in as little as 45 minutes.

At present, medics can sometimes give out antibiotics unnecessarily because it is not clear whether an infection is caused by bacteria (which antibiotics can treat) or viruses (for which they are ineffective).

The new trial hopes to overcome this by giving rapid results so prescriptions can be given more accurately.

Global health chiefs are determined to slow down the rise in antimicrobial resistance (AMR), which is part-fuelled by unnecessary use of antibiotics.

AMR occurs when bacteria, viruses, fungi and parasites mutate and no longer respond to the medicines – including antibiotics – designed to treat them.

This makes illnesses hard to treat and increases the risk of diseases spreading, causing severe illness or death.

Antibiotic resistance occurs naturally but the overuse of antibiotics can speed up the process.

The use of antibiotics in the UK fell by 15% between 2017 to 2021 but there are plans to cut this even further.

Data from the UK Health Security Agency shows there was an average of 148 severe antibiotic-resistant infections per day in 2021, up by 2.2% on the previous pandemic year (53,985, up from 52,842).

The new clinical trial is being made possible by £1.6 million in funding from the National Institute for Health and Care Research.

Professor Alastair Hay, a GP and chief investigator of the study, said: “Industry is investing a lot of money in the development of these tests and the potential future cost to the NHS is high.

“It’s therefore important we are confident they are a good use of scarce NHS funds before they are introduced into routine care.

“A well-conducted clinical trial, like Rapid-Test, is the best way to find out.

“Although it may at first seem obvious that they should be used, there are other factors to consider in addition to cost.

“For example, when a virus is detected it does not mean it is causing the infection. Some viruses can live harmlessly in our noses and throats.

“So nurses and GPs must still use their judgement about whether a bacterial infection is also present.

It’s important we are confident they are a good use of scarce NHS funds PROFESSOR ALASTAIR HAY

“Second, no test is 100% accurate. It might say ‘no virus’ when an important virus is present. This means patients could be given the wrong advice or treatment.

“Finally, the decision to prescribe antibiotics can be influenced by factors outside the test results, such as the patient-clinician interaction and patients’ expectations for antibiotics.

“We will consider all of these factors in this trial and will also look at whether the use of rapid point-of-care tests helps patients feel better quicker.

“If the tests are shown to be effective in reducing antibiotic prescribing, we will do further research on their costeffectiveness.”

GP practices in the South West of England who wish to take part should contact the study team at rapidteststudy@bristol.ac.uk