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The following is a summary of “Point-of-care testing reduces antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis,” published in the March 2025 issue of International Journal of Infectious Diseases by Li et al. 

Challenges in determining the causes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) led to excessive antibiotic use, while point-of-care testing (POCT) offered potential benefits for pathogen identification and appropriate antibiotic use.  

Researchers conducted a retrospective study to evaluate the impact of POCT on guiding antibiotic prescriptions for AECOPD.  

They evaluated the effect of POCT on guiding antibiotic prescriptions for AECOPD, following a predefined protocol (CRD42024555847). Eligible studies were determined by searches in Medline, Web of Science, Embase, Scopus, and Cochrane Library from their inception to March 2024, focusing on English-language human studies. The analysis included antibiotic-related and clinical outcomes, with a risk of bias evaluation and meta-analyses performed based on POCT type and testing timing. The search strategy incorporated Medical Subject Headings (MeSH) and text words for chronic obstructive pulmonary disease (COPD), antibiotics, and POCT.  

The results showed that 18 studies involving 4,346 individuals with AECOPD were included. The POCT significantly reduced antibiotic prescriptions by 16% (P < 0.001) and shortened antibiotic treatment duration by 1.19 days (P = 0.04). No adverse effects were observed on clinical outcomes, including hospital length of stay (P = 0.19). Sensitivity analyses confirmed these findings.  

Investigators concluded that they had provided reasonable evidence supporting the use of POCT to decrease antibiotic exposure for AECOPD without negatively impacting clinical outcomes and that the adoption of POCT should be promoted, given the growing significance of diagnostics in the fight against antimicrobial resistance. 

Source: ijidonline.com/article/S1201-9712(25)00112-2/fulltext