New device will help GPs decide if patient needs an antibiotic

A device that sits easily on a GP's desk could make a huge contribution to the fight against superbugs.

GPs could use the device to get rapid finger prick blood test results when deciding if a patient needs an antibiotic.

Currently, around 2.4m prescriptions are issued for respiratory tract infections in Ireland each year.

The Health Information and Quality Authority found point-of-care testing could halve the annual number of antibiotic prescriptions for respiratory tract infections.

The authority is recommending that a pilot programme is carried using the technology before deciding on a national roll-out.

Hiqa's chief scientist Dr Conor Teljeur said GPs could use a device to measure a protein in the liver within about 10 minutes.

Dr Teljeur said there were too many antibiotics given out at present. “Part of that is the lack of easy access to testing,” he said.

The test that measures the C-reactive protein in the liver has been used for a number of years but new smaller and simpler devices are now emerging.

“Currently, GPs have to send a blood sample to a hospital laboratory to be tested but the turnaround is longer. It could be late in the day before they get a response,” said Dr Teljeur.

Hiqa's health technology assessment that took about a year to complete confirmed that the technology could have a huge impact on antibiotic prescribing.

However, there is a lack of evidence as to whether the test works for children.

Dr Teljeur said they only examined the point-of-care test in relation to respiratory tract infections but it could be used for other infections.

Respiratory tract infections include pneumonia, bronchitis, tonsillitis and the common cold.

In about two-thirds of cases, GPs can figure out whether or not a patient needs an antibiotic based on signs and symptoms and what the patient tells them.

However, in a third of cases, it is not immediately clear whether a patient needs an antibiotic and GPs could use a device to quickly determine whether or not it would be useful to prescribe antibiotics.

Asked how big the pilot programme would be, Dr Teljeur said that would be a matter for the HSE.

They (HSE) would have to figure out what information they needed to know about implementing it. We don't tell them how to implement it; we provide advice.

Dr Teljeur said the report did not deal with the future cost of antimicrobial resistance – a growing problem in Ireland.

Some people who took antibiotics did not complete the course or took antibiotics when they did not need them.

“And what that means is that later on – in a few years down the line, people will need an antibiotic for something serious and it will no longer work as a treatment.”

The five-year cost of the rapid test is put at between €1m and €5m depending on whether there is enhanced communications skills training.

However, if GPs were to be paid per test the five-year cost would increase by between €8m and €54m.