Completed Digestion, Kidneys & Other Organs NIHR-supported project Public Health & Healthcare

POCT65ABX - POCT to Reduce Antibiotics for LRTI in Older Adults in Primary Care

Funder NIHR (part of DHSC)
Recipient organisation NIHR Southampton Biomedical Research Centre
NIHR support Recorded as supported by this research centre
Period Jan 2025 — Sept 2025

In plain English

AI plain-English summary

GPs prescribe antibiotics for chest infections in older adults even when the infection is likely viral, because they cannot easily tell the difference during a short appointment. This matters because unnecessary antibiotics fuel drug-resistant bacteria and cause side effects in patients, yet doctors have no quick, reliable way to rule out bacterial infection at the point of care. Current practice relies on clinical judgment alone, which often defaults to prescribing “just in case.” The problem is worse for older adults, who are more prone to secondary bacterial infections, making GPs even more cautious. This feasibility trial tests whether a larger study is possible—one that would use point-of-care tests during GP appointments to detect bacterial versus viral causes of chest infections. If the larger study eventually shows that such tests reduce unnecessary prescribing, the impact would be twofold: fewer antibiotics wasted on viral infections, preserving their effectiveness for when they are truly needed, and fewer patients suffering avoidable side effects. The change would happen inside the GP surgery, during the consultation itself, without requiring patients to visit a lab or wait for results.

View original technical description
One of the main reasons for GPs prescribing antibiotics is for flu-like illnesses such as chest infections. Antibiotics are only work against bacteria. However, most chest infections are caused by viruses. This means a lot of prescribed antibiotics are not needed. This happens even more for older adults, as they are more likely to have another infection caused by a bacteria. Prescribing too many antibiotics is harmful as it can stop them working due to resistance, making it harder to treat chest infections in the future. Unnecessary antibiotics can also be bad for the patient because they may get unwanted side effects from taking them. Because of this, antibiotics should only be given when necessary. Right now, it can be very hard to tell what chest infections are caused by a bacteria or a virus. Point-of-care testing can be used to help find out if a bacteria or a virus is causing a chest infection and help GPs know if they should prescribe antibiotics. For example, if a point-of-care test is done during an appointment and is positive for a bacteria, then the GP will have a better idea if antibiotics are needed. This trial will see whether it is possible to conduct a trial investigating if using point-of-care tests can reduce unnecessary antibiotic prescribing for chest infections. This will be a small, feasibility study to see if a bigger study is possible. While some data will be gathered about antibiotic prescribing, the study will mainly focus on recruitment, follow up rate, opinions from clinicians and participants, and how well the trial protocol works in practice. By doing this research, we will be one step closer to performing a study to understand how point-of-care testing would work in primary care

Researchers

Mark Lown (Principal Investigator)

Related Research

Grants with similar aims, by meaning.

Point-of-care testing to improve the use of antibiotics for acute respiratory tract infections in primary care
AFLOAT - Placebo-controlled RCT of antibiotics for lower respiratory tract infection in older people presenting in primary care.
Antibiotics For uncomplicated Lower Respiratory Tract Infections in Older AdulTs - AFLOAT
Rapid respiratory microbiological point-of-care-testing in primary care: a randomised controlled trial with internal pilot and qualitative and quantitative investigation of microbial, behavioural and antibiotic mechanisms (the RAPID-TEST RCT)
Point of care testing using FebriDx to improve antibiotic use for respiratory tract infections in primary care: a mixed methods feasibility study

Original classification

Microbiology, Immunology and Infection (MII)

Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.