Point-of-Care Testing Cuts Antibiotic Use in Pharyngitis

Medscape

4 days ago

TOPLINE:
Point-of-care testing for group A beta-hemolytic Streptococcus (Strep A) significantly reduced antibiotic prescriptions in children and adults with signs of pharyngitis, even when used as the sole intervention.
METHODOLOGY:
Researchers performed a meta-analysis of eight randomized controlled trials conducted between 2007 and 2021, evaluating point-of-care testing for Strep A vs standard care.
The analysis included 4249 children and adults with pharyngitis, cough, or sore throat who underwent point-of-care testing for Strep A either alone or alongside other interventions.
Primary outcomes were the impacts on antibiotic prescriptions, clinical decisions, and patient health outcomes.
Secondary endpoints assessed diagnostic accuracy of Strep A testing, including sensitivity and specificity measurements.
TAKEAWAY:
Point-of-care testing reduced antibiotic prescriptions by 38% compared with standard care (risk ratio [RR], 0.62; P < .0001) and by 41% when it was the sole intervention (RR, 0.59; P < .001).
The implementation of point-of-care testing also led to a reduction in inappropriate antibiotic prescriptions (RR, 0.45; 95% CI, 0.31-0.97; P = .038).
However, there were no significant differences in the patient health outcomes, such as days until pain resolution and days of school/work missed, the use of ancillary testing, or other medications such as analgesics with point-of-care testing.
The reported diagnostic accuracy of Strep A point-of-care testing showed sensitivity ranging from 65% to 94% and specificity from 85% to 94%.
IN PRACTICE:
'Physicians can therefore use Strep A POCTs [point-of-care tests] to inform their decisions on antibiotic prescribing without compromising patient health outcomes. In clinical practice, physicians must be aware of the limitations of Strep A POCTs, in particular, the limited sensitivity for detecting GAS [group A beta-hemolytic Streptococcus],' the authors of the study wrote.
SOURCE:
This study was led by Ann-Sophie Mägdefrau and Carolin Kathner-Schaffert, Jena University Hospital and InfectoGnostics Research Campus Jena, both in Jena, Germany. It was published online on July 9, 2025, in Open Forum Infectious Diseases.
LIMITATIONS:
High statistical heterogeneity in the meta-analyses limited the precision of the pooled effect estimates. Only three trials reported patient health outcomes, restricting evaluation of the effect of Strep A point-of-care tests on measures like recovery time. Additionally, none of the trials were blinded, introducing potential bias — particularly in evaluating subjective outcomes like pain and symptom resolution.
DISCLOSURES:
This study received funding from the German Federal Ministry of Education and Research. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.