Host immune response point-of-care testing for children and adults presenting to primary care with acute upper respiratory tract infection: a mixed-methods feasibility study

PI Title: Dr Emily Brown 

Lead member: Bristol

"Improving antibiotic use for upper respiratory infections in GP practices

Antibiotics only work for infections caused by bacteria. They do not work if the infection is caused by a virus. If antibiotics are given too often, they can stop working. When antibiotics stop working this is called “antimicrobial resistance” (AMR). This means infections caused by bacteria are difficult to treat and people might die. By 2050, AMR could cause more deaths than cancer.

Using fewer antibiotics means less AMR. Most antibiotics are given in GP practices. The reason too many antibiotics are given is because it is often hard to tell if an infection is caused by bacteria or by a virus. Antibiotics are often given for infections caused by viruses, like sore throats and sinus infections. Infections in the ear, throat, nose or sinuses, but not the lungs, are known as “upper respiratory infections”. The UK government wants tests that can show if an infection is bacterial or viral. Quick tests, used close to where patients are seen, like GP practices, are called ‘point-of-care tests’ (POCTs).

A new, quick POCT, called FebriDx®, uses a tiny ‘finger-prick’ blood sample to measure how a patient’s immune system is reacting to the infection. The result can help healthcare staff know if the infection is viral or bacterial. This POCT has been used in hospitals, but not in GP practices. We want to see if FebriDx® will work in GP practices.

We will invite GP practices to test adults and children with upper respiratory infections using FebriDx®.

We want to know:
1. How often healthcare staff use the test and who they test
2. If the test changes what healthcare staff think caused the infection and whether antibiotics are needed
3. How good the test is at telling the difference between viral and bacterial infections

We will interview patients, GPs, nurses and other staff to find out how they got on with the test.

Patients and members of the public helped design this study, agreed it is worth doing and that the ‘finger-prick’ test was the right test to use. We will work with this group to review study documents, decide how the study should progress and what the results mean.

We will share our results with:
1. The public, using our website, social media and local events
2. The research community in scientific publications and at conferences
3. The NHS and policymakers

If the test is practical, acceptable to patients, and may reduce antibiotic use, we plan to do a larger study. The larger study will find out if this test can be used in all GP practices to help reduce antibiotic use and the amount of AMR.
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