Trials of new point of care tests to help reduce overuse of antibiotics

The trials, currently underway across a number of Geelong GP clinics, involve a simple finger prick or throat swab that provide immediate results about whether a patient's infection is bacterial, and requires antibiotics, or viral, and alternative treatment is needed.

Dr Sajal Saha, Research Fellow in the Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), a partnership between Deakin's School of Medicine and Barwon Health, said the tests can help clinicians more accurately diagnose the cause of infection and allow for better targeted treatment, potentially reducing the problem of overprescription of antibiotics, not just in Australia but globally.

'The finger prick test has been trialled internationally, but we don't have the data needed to show its effectiveness and cost-effectiveness in reducing antibiotic over prescription in Australia,' Dr Saha said.

'It is a simple, low-cost test and early results from two GP clinics in Geelong show it can reduce antibiotic use by up to 30 per cent.

'This is because it allows doctors to assess whether a range of common respiratory infections are the result of bacterial infections or viral infection and whether the infection is severe enough for antibiotic treatment.

'This is an important distinction because we know that too often antibiotics are prescribed for viral illnesses that won’t respond to antibiotics and for less severe infection that doesn’t need antibiotics.

'The second test currently being trialled in five GP clinics across Geelong is a throat swab that enables doctors to confirm within minutes whether a sore throat is caused by Strep A bacteria.

'Strep A is a common cause of throat infection and doctors prescribe antibiotics in around 70 per cent of cases. But Strep A is only responsible for around 15 to 20 percent of sore throats so the level of overprescription is very high.

'In children Strep A can lead to rheumatic heart conditions so it is absolutely vital that it is properly diagnosed and treated early and effectively before it develops into more serious illness. This throat swab test will ensure optimal antibiotic treatment for Strep A.'

The research team has been running a feasibility trial in 2024 that involved testing around 200 people across five clinics for four months; a pilot trial in 2025 involving around 400 patients will further assess its effectiveness in reducing antibiotic use

CIIDIR Co-Director, Professor Eugene Athan said both trials had potential to significantly improve the safe use of antibiotics.

'Australia is one of the highest antibiotic prescribing countries in the developed world,' Professor Athan said.

'The unnecessary use of antibiotics – taking them when not needed, for longer than required or an incorrect dose - causes antibiotics to become ineffective over time, a phenomenon called antimicrobial resistance (AMR).

'AMR is making infections harder to treat and increasing the risk of disease, severe illness and deaths. It's the cause of death for 700,000 people worldwide each year.

'Compared to national guideline recommendations, antimicrobials continue to be overprescribed in Australia, with 30 to 50% of prescriptions in primary care inappropriate either in choice, dose or duration,' Professor Athan said.

Dr Saha said many people expected or demanded antibiotics from doctors and misused antibiotics by failing to take their dosage correctly or used their antibiotic course against recommendations.

'Doctors cite a number of reasons for unnecessary prescriptions, including diagnostic uncertainty regarding the cause of infection, patient and parent self-diagnosis and limited training and resources,' Dr Saha said.

'This work is trying to improve the capacity of GPs and community pharmacists with point-of-care diagnostic testing services. This will help prescribers better understand the severity of infections or confirm bacterial infections for some respiratory infections during patient consultations and prescribe antibiotics accordingly.'