Can the use of 'rapid diagnostic' devices (that turn the results of tests round in hours rather than days) at a patient's bedside help reduce the amount of inappropriate prescribing of antibiotics and ensure appropriate treatment and care is given?
If a patient develops an infection, doctors need to know its cause before starting treatment. But the results of tests to confirm the cause of infection – and therefore inform the choice of treatment – often take one or two days to come through.
Antibiotics may be ineffective for infections caused by viruses, or may not be necessary.
Yet because of the time taken by laboratories to process diagnostic tests, doctors often go ahead and prescribe broad-spectrum antibiotics in the first instance – and sometimes patients are admitted to hospital pending the laboratory results.
The infection research team is evaluating different types of rapid diagnostic devices to find out how cost-effective they are, if they reduce the number of unnecessary antibiotics prescribed – and whether they reduce the number of people admitted to hospital.
The researchers are working with three different companies – Alere, BioFire Defense and Enigma Diagnostics – who have each donated hundreds of diagnostic kits that are being road-tested in accident and emergency departments and admission wards (for both adults and children) at King's College Hospital, Guy's and St Thomas' Hospitals and St George's Hospital. All the tests detect winter bugs.
At St George's, the information collected will also be used in a project that is focusing on how to prevent unnecessary admission to hospital. Wandsworth Clinical Commissioning Group is financially supporting this complementary project: the CCG has funded a research fellow for two years who has also been working on the CLAHRC South London evaluation project.
Contributory funding for the CLAHRC South London project has also come from King's College Hospital NHS Foundation Trust and Enigma Diagnostics.
At May 2016, rapid diagnostic testing had been used on more than 2,300 patients.