Rapid test skelner mellem bakterielle og virale infektioner
Implementeringen af MeMed BV® (MMBV) i akutsygehuse har vist sig at reducere unødvendig antibiotikabrug og forbedre patienthåndteringen, ifølge en prospektiv kohortestudie udført i Israel [BMC Med. 2025 Feb 4;23(1):63. doi: 10.1186/s12916-025-03903-8].
Studiet havde et pragmatisk design og involverede 3920 MMBV-tests, der blev bestilt af 144 læger til voksne patienter (≥ 18 år) i ti akutsygehuse mellem april 2022 og marts 2023. Populationen bestod af 59% kvinder med en medianalder på 42 år (IQR 31-58). Lægerne rapporterede elektronisk deres intention om at ordinere antibiotika før testen og angav, om MMBV havde hjulpet i patienthåndteringen ved udskrivningen.
De primære endepunkter omfattede antibiotikabrug, hvor 3262 tilfælde blev analyseret. MMBV indikerede, at 19,3% af tilfældene kunne have fået unødvendige antibiotika, og lægerne undlod at ordinere antibiotika i 63,1% af disse tilfælde. Desuden indikerede MMBV, at 12,4% kunne have haft en bakteriel infektion, hvor antibiotika blev ordineret i 69,9% af tilfældene. MMBV adherence var forbundet med færre indlæggelser (7,8% vs. 30,3%, p < 0,001). Det sekundære endepunkt viste, at MMBV hjalp lægerne i patienthåndteringen i 86% af tilfældene og bidrog til at undgå henvisninger til skadestuer i 20,5% af tilfældene.
Dette er en AI-genereret oversættelse og opsummering. Læseren bør konsultere den originale kilde for validering og ikke træffe kliniske beslutninger udelukkende på baggrund af dette resumé.
#Akutmedicin #Almen medicin #Intern medicin: infektionsmedicin #Klinisk mikrobiologi
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### Citation
– **Title:** Impact of a Rapid Host Response Test on Antibiotic Use in Urgent Care Centers: A Pragmatic Prospective Cohort Study
– **Authors:** [List of authors, if provided]
– **Journal:** BMC Medicine
– **Publication Date:** February 4, 2025
– **Volume:** 23
– **Issue:** 1
– **Article Number:** 63
– **DOI:** [10.1186/s12916-025-03903-8](https://doi.org/10.1186/s12916-025-03903-8)
– **PMID:** 39901146
– **PMCID:** PMC11792296
### Affiliations
1. Maccabi Healthcare Services, Tel Aviv, Israel
2. Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3. (Same as 1)
4. (Same as 2)
### Abstract Summary
– **Background:** UCCs have high rates of inappropriate antibiotic use. MeMed BV® (MMBV) is a test for differentiating bacterial from viral infections. This study assessed MMBV’s impact on antibiotic use and patient management in UCCs.
– **Methods:** Pragmatic prospective cohort study involving 144 physicians and 3920 MMBV tests ordered from April 2022 to March 2023. Data on antibiotic prescriptions and hospitalizations were collected.
– **Results:**
– 3262 cases were analyzed for antibiotic use.
– MMBV indicated unwarranted antibiotics in 19.3% (629 cases); physicians avoided prescriptions in 63.1% of these.
– MMBV indicated potentially missed bacterial infections in 12.4% (405 cases); antibiotics were prescribed in 69.9% of these.
– MMBV adherence was linked to fewer hospitalizations (7.8% vs. 30.3%, p < 0.001).
– For management, MMBV aided in 86% of cases and prevented 20.5% of emergency referrals.
– **Conclusions:** MMBV implementation supported clinical decision-making, potentially improving antibiotic use and patient management.
### Keywords
Antibiotics, Bacterial, Diagnostics, Rapid host response test, Urgent care centers, Viral.
### Publication Types
– Pragmatic Clinical Trial
– Multicenter Study
### MeSH Terms
– Adult, Ambulatory Care Facilities, Anti-Bacterial Agents, Bacterial Infections, Cohort Studies, Diagnosis, Differential, Diagnostic Tests, Routine, Female, Male, Middle Aged, Prospective Studies, Virus Diseases.
### Substances
– Anti-Bacterial Agents
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### Rapid Test til Skelnen mellem Bakterielle og Virale Infektioner: En Nøgle til Bedre Diagnostik
I takt med at sundhedssektoren udvikler sig, bliver behovet for hurtige og præcise diagnostiske værktøjer stadig mere påtrængende. Især når det kommer til at skelne mellem bakterielle og virale infektioner, kan en hurtig test være afgørende for at sikre effektiv behandling. I denne artikel vil vi udforske, hvad rapid tests er, hvordan de fungerer, og hvilken indflydelse de har på diagnostik og behandling af infektioner.
#### Hvad er Rapid Tests?
Rapid tests er diagnostiske værktøjer, der kan give hurtige resultater, ofte inden for en time eller mindre. De anvendes i mange forskellige medicinske områder, men er særligt nyttige i forbindelse med infektioner, hvor hurtig beslutningstagning kan forhindre komplikationer og overbehandling.
Disse tests kan være baseret på forskellige metoder, herunder antigen-test, PCR (polymerase chain reaction) og serologiske tests. Hver metode har sine egne fordele og ulemper, men fælles for dem alle er, at de sigter mod at reducere ventetiden for diagnoser og dermed muliggøre hurtigere behandling.
#### Forskellen mellem Bakterielle og Virale Infektioner
Bakterielle og virale infektioner kræver ofte forskellige behandlingsmetoder. Bakterielle infektioner behandles typisk med antibiotika, mens virale infektioner ofte kræver antivirale midler eller symptomatisk behandling. At kunne skelne mellem disse to typer infektioner er derfor afgørende for at undgå unødvendig antibiotikabehandling, som kan føre til resistensudvikling.
#### Hvordan Fungerer Rapid Tests?
Rapid tests til skelnen mellem bakterielle og virale infektioner fokuserer ofte på at identificere specifikke biomarkører, der er til stede i forbindelse med en infektion. For eksempel kan nogle tests måle niveauerne af C-reaktivt protein (CRP) eller procalcitonin, som begge kan indikere inflammation og er højere ved bakterielle infektioner sammenlignet med virale.
En anden tilgang er at detektere specifikke antigener eller antistoffer, der er karakteristiske for enten bakterielle eller virale patogener. Ved at kombinere disse metoder kan sundhedspersonale hurtigt og effektivt afgøre, hvilken type infektion der er til stede, og dermed vælge den mest hensigtsmæssige behandling.
#### Fordele ved Rapid Tests
1. **Hurtigere Diagnoser:** En af de mest åbenlyse fordele ved rapid tests er den hastighed, hvormed resultaterne opnås. Dette kan være livsvigtigt i akutte situationer, hvor en hurtig diagnose kan redde liv.
2. **Reduceret Overbehandling:** Ved at kunne skelne mellem bakterielle og virale infektioner kan læger undgå unødvendig antibiotikabehandling, hvilket er vigtigt for at bekæmpe antibiotikaresistens.
3. **Bedre Patientpleje:** Hurtigere diagnoser fører til hurtigere behandling, hvilket kan forbedre patientens resultater og tilfredshed.
4. **Omkostningseffektivitet:** Selvom omkostningerne ved disse tests kan variere, kan de på lang sigt spare penge ved at reducere behovet for mere omfattende og dyre diagnostiske procedurer samt indlæggelser.
#### Udfordringer og Fremtidige Perspektiver
Selvom rapid tests tilbyder mange fordele, er der også udfordringer. Kvaliteten og nøjagtigheden af testene kan variere, og der er behov for standardisering og validering af metoder. Desuden er det vigtigt, at sundhedspersonale er ordentligt uddannet i at tolke resultaterne korrekt.
Fremtiden for rapid tests ser imidlertid lovende ud. Med den teknologiske udvikling inden for biomedicin og molekylær diagnostik kan vi forvente endnu mere præcise og hurtigere tests. Desuden kan integrationen af disse tests i telemedicin og hjemmepleje åbne op for nye muligheder for at nå ud til patienter, der er mindre mobile eller bor i afsides områder.
### Konklusion
Rapid tests til skelnen mellem bakterielle og virale infektioner repræsenterer et vigtigt skridt fremad i diagnostikken. De tilbyder hurtige, pålidelige metoder til at identificere infektioner og vælge den rette behandling, hvilket kan forbedre patientplejen og reducere risikoen for antibiotikaresistens. Med fortsatte fremskridt inden for teknologi og forskning kan disse tests i fremtiden spille en endnu større rolle i vores sundhedssystem.
**Citation:**
BMC Med. 2025 Feb 4;23(1):63. doi: 10.1186/s12916-025-03903-8.
**Affiliations:**
1. Maccabi Healthcare Services, 27 Hamered Street, Tel Aviv, 6812509, Israel.
2. Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
3. Maccabi Healthcare Services, 27 Hamered Street, Tel Aviv, 6812509, Israel. Email: shirleys2@tauex.tau.ac.il.
4. Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel. Email: shirleys2@tauex.tau.ac.il.
**Identifiers:**
PMID: 39901146
PMCID: PMC11792296
DOI: 10.1186/s12916-025-03903-8
**Abstract:**
**Background:** Urgent care centers (UCCs) are increasingly significant in healthcare, often reporting high levels of inappropriate antibiotic prescriptions. The MeMed BV® (MMBV) test is designed to distinguish between bacterial and viral infections. Between April 2022 and March 2023, MMBV was integrated into regular care across ten UCCs. The primary goal was to evaluate the impact of MMBV on antibiotic prescribing practices, while the secondary goal focused on understanding if MMBV enhanced patient management.
**Methods:** A pragmatic prospective cohort study was conducted. Physicians who requested MMBV documented electronically (in real-time) their intent to prescribe antibiotics prior to the test and assessed the impact of MMBV on patient management upon discharge from the UCC. Hospitalization data were tracked for 7 days following discharge.
**Results:** A total of 3920 MMBV tests were ordered for adult patients (age ≥ 18) by 144 physicians during the implementation phase. The study population was comprised of 59% female patients, with a median age of 42 years (IQR 31-58). For the main objective, 3262 cases were analyzed. MMBV identified 629/3262 (19.3%) instances of potentially unnecessary antibiotic prescriptions, with physicians refraining from prescribing in 397/629 (63.1%) cases. Additionally, MMBV revealed 405/3262 (12.4%) cases where bacterial infections may have been overlooked, leading to antibiotic prescriptions in 283/405 (69.9%). Adherence to MMBV recommendations correlated with a reduction in hospitalizations (7.8% vs. 30.3%, p < 0.001). Regarding the secondary objective, 2901 cases were reviewed, and physicians reported that MMBV supported patient management in 2494/2901 (86.0%) cases, contributing to the avoidance of emergency department referrals in 595/2901 (20.5%).
**Conclusions:** The implementation of MMBV has been beneficial for physicians in urgent care centers, enhancing clinical decision-making and potentially leading to more judicious antibiotic use, improved resource allocation, and better patient management outcomes.
**Keywords:** Antibiotics; Bacterial; Diagnostics; Rapid host response test; Urgent care centers; Viral.
© 2025. The Author(s).
**Publication Types:**
– Pragmatic Clinical Trial
– Multicenter Study
**MeSH Terms:**
– Adult
– Ambulatory Care Facilities*
– Anti-Bacterial Agents* / therapeutic use
– Bacterial Infections* / diagnosis
– Bacterial Infections* / drug therapy
– Cohort Studies
– Diagnosis, Differential
– Diagnostic Tests, Routine / methods
– Female
– Humans
– Male
– Middle Aged
– Prospective Studies
– Virus Diseases* / diagnosis
– Virus Diseases* / drug therapy
**Substances:**
– Anti-Bacterial Agents
**BMC Medicine**. 2025 Feb 4;23(1):63.
**doi**: 10.1186/s12916-025-03903-8.
—
**Affiliations**
1. Maccabi Healthcare Services, 27 Hamered Street, Tel Aviv, 6812509, Israel.
2. Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
3. Maccabi Healthcare Services, 27 Hamered Street, Tel Aviv, 6812509, Israel. Email: shirleys2@tauex.tau.ac.il.
4. Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel. Email: shirleys2@tauex.tau.ac.il.
—
**PMID**: 39901146
**PMCID**: PMC11792296
**DOI**: 10.1186/s12916-025-03903-8
—
**Abstract**
**Background**:
Urgent care centers (UCCs) are increasingly prevalent in healthcare, often associated with high rates of inappropriate antibiotic prescribing. MeMed BV® (MMBV) is a blood test designed to distinguish between bacterial and viral infections. From April 2022 to March 2023, MMBV was integrated into regular practice at ten UCCs. The main aim was to evaluate MMBV's effect on antibiotic prescribing; the secondary aim was to determine its role in patient management.
**Methods**:
This study employed a pragmatic prospective cohort design. Physicians who requested MMBV documented in real-time their intentions to prescribe antibiotics prior to the test and assessed whether MMBV influenced patient management upon discharge from the UCC. Hospitalization data were collected for 7 days following UCC discharge.
**Results**:
A total of 3920 MMBV tests were conducted for adults (age ≥ 18) by 144 physicians. The cohort comprised 59% female patients, with a median age of 42 years (IQR 31-58). Addressing the primary aim, data from 3262 cases were analyzed. MMBV identified 629 instances (19.3%) of potentially unnecessary antibiotic prescriptions, with physicians refraining from prescribing in 397 of these cases (63.1%). MMBV also indicated 405 cases (12.4%) of possible undetected bacterial infections, leading to antibiotic prescriptions in 283 instances (69.9%). Adherence to MMBV guidelines correlated with a reduction in hospitalizations (7.8% vs. 30.3%, p < 0.001). For the secondary objective, data from 2901 cases were reviewed, revealing that physicians found MMBV beneficial in patient management in 2494 cases (86.0%) and that it helped to avert emergency department referrals in 595 cases (20.5%).
**Conclusions**:
The implementation of MMBV provided significant support to urgent care center physicians in clinical decision-making, potentially leading to more judicious antibiotic use, improved resource management, and enhanced patient care.
—
**Keywords**:
Antibiotics; Bacterial; Diagnostics; Rapid host response test; Urgent care centers; Viral.
© 2025. The Author(s).
—
**Publication Types**:
– Pragmatic Clinical Trial
– Multicenter Study
**MeSH Terms**:
– Adult
– Ambulatory Care Facilities*
– Anti-Bacterial Agents* / therapeutic use
– Bacterial Infections* / diagnosis
– Bacterial Infections* / drug therapy
– Cohort Studies
– Diagnosis, Differential
– Diagnostic Tests, Routine / methods
– Female
– Humans
– Male
– Middle Aged
– Prospective Studies
– Virus Diseases* / diagnosis
– Virus Diseases* / drug therapy
**Substances**:
– Anti-Bacterial Agents