Pneumococcal urinary antigen testing (PUAT) may be a useful antibiotic stewardship tool when diagnosing and treating pneumonia, pharmacist-researchers say.
PUAT is a rapid test that can be used to diagnose community-acquired pneumonia caused by Streptococcus pneumoniae. The researchers analyzed healthcare data from acute-care patients at New York University Langone Health after the hospital instituted new guidelines to include the test for suspected pneumonia cases.
Patients with positive test results were more likely to come off antibiotics earlier than the PUAT negative group, the investigators found. Within 24 hours of testing, more patients in the PUAT positive group were switched from broad-spectrum antibiotics — which are given to cover atypical organisms — to a more targeted antibiotic. There was no difference in reducing or switching of antibiotics targeting possible MRSA or pseudomonas infections, however.
In addition, patients with positive PUAT and whose antibiotics prescriptions were reduced or switched also had shorter stays than those who did not, according to researcher Yanina Dubrovskaya, PharmD.
Notably, there was no difference in the incidence of Clostridioides difficile (C. diff) infections, in-hospital mortality or 30-day infection-related readmission between the groups, she and her colleagues reported.
These results suggest that clinicians were able to more quickly narrow down potential pneumonia causes and reduce at least some unnecessary antibiotic use. The tests will therefore be most useful as part of a larger antibiotic-reduction strategy, they concluded.
The study was published in Open Forum Infectious Diseases.
