Use of rapid influenza testing to reduce antibiotic prescriptions among outpatients with influenza-like illness in southern Sri Lanka

L. Gayani Tillekeratne, Champica K. Bodinayake, Ajith Nagahawatte, Dhammika Vidanagama, Vasantha Devasiri, Wasantha Kodikara Arachchi, Ruvini Kurukulasooriya, Aruna Dharshan De Silva, Truls Østbye, Megan E. Reller, Christopher W. Woods

Research output: Contribution to journalArticle

Abstract

Acute respiratory tract infections (ARTIs) are a common reason for unnecessary antibiotic prescriptions worldwide. Our objective was to determine if providing access to rapid influenza test results could reduce antibiotic prescriptions for ARTIs in a resource-limited setting. We conducted a prospective, pre-post study from March 2013 to October 2014. Outpatients presenting to a hospital in Sri Lanka were surveyed for influenza-like illness-onset of fever ? 38.0C and cough in prior 7 days. Enrolled patients were administered a structured questionnaire, physical examination, and nasal/nasopharyngeal sampling for rapid influenza A/B testing. Influenza test results were released only during phase 2 (January-October 2014). We enrolled 571 patients with ILI-316 in phase 1 and 241 in phase 2. The proportion positive for influenza was 46.5% in phase 1 and 28.6% in phase 2, P < 0.001. Between phases, antibiotic prescriptions decreased from 81.3% to 69.3% (P = 0.001) among all patients and from 83.7% to 62.3% (P = 0.001) among influenza-positive patients. On multivariable analysis, a positive influenza result during phase 2 was associated with lower odds of antibiotic prescriptions (OR = 0.50, 95% CI = 0.26-0.95). This prospective study suggests that providing access to rapid influenza testing may reduce unnecessary antibiotic prescriptions in resource-limited settings.

Original languageEnglish (US)
Pages (from-to)1031-1037
Number of pages7
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume93
Issue number5
DOIs
StatePublished - Nov 4 2015

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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