Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun;12(6):1445-1463.
doi: 10.1007/s40121-023-00815-z. Epub 2023 Jun 1.

Rapid Diagnostic Test Value and Implementation in Antimicrobial Stewardship Across Low-to-Middle and High-Income Countries: A Mixed-Methods Review

Luke S P Moore  1   2   3 , Maria Virginia Villegas  4   5 , Eric Wenzler  6 , Timothy M Rawson  7   8 , Rita O Oladele  9 , Yohei Doi  10   11   12 , Anucha Apisarnthanarak  13   14
Affiliations

Rapid Diagnostic Test Value and Implementation in Antimicrobial Stewardship Across Low-to-Middle and High-Income Countries: A Mixed-Methods Review

Luke S P Moore et al. Infect Dis Ther. 2023 Jun.

Abstract

Despite technological advancements in infectious disease rapid diagnostic tests (RDTs) and use to direct therapy at the per-patient level, RDT utilisation in antimicrobial stewardship programmes (ASPs) is variable across low-to-middle income and high-income countries. Key insights from a panel of seven infectious disease experts from Colombia, Japan, Nigeria, Thailand, the UK, and the USA, combined with evidence from a literature review, were used to assess the value of RDTs in ASPs. From this, a value framework is proposed which aims to define the benefits of RDT use in ASPs, separate from per-patient benefits. Expert insights highlight that, to realise the value of RDTs within ASPs, effective implementation is key; actionable advice for choosing an RDT is proposed. Experts advocate the inclusion of RDTs in the World Health Organization Model List of essential in vitro diagnostics and in iterative development of national action plans.

Keywords: Antimicrobial resistance; Antimicrobial stewardship; Antimicrobial stewardship programmes; High-, middle-, and low-income countries; Infectious disease RDT; Point-of-care testing; Rapid diagnostic tests.

PubMed Disclaimer

Conflict of interest statement

Luke S. P. Moore has consulted for or received speaker fees from bioMerieux (2013–2022), Pfizer (2018–2022), Eumedica (2016–2022), Kent Pharma (2021), Umovis Lab (2020–2021), Shionogi (2021–2022), Pulmocide (2021), Sumitovant (2021–2022), and received research grants from the National Institute for Health Research (2013–2022), CW+ Charity (2018–2022), Infectopharm (2022), and LifeArc (2020–2022). Anucha Apisarnthanarak declares no competing interests. Eric Wenzler reports grants from Qiagen and Shionogi Inc (research grant paid to institution), and personal fees from Abbvie Inc, Ferring Pharmaceuticals, Qiagen, Melinta Therapeutics, Astellas Pharma and Venatorx Pharmaceuticals. Maria Virginia Villegas reports grants from Pfizer and bioMerieux, personal fees from Pfizer, MSD and bioMerieux and support for meetings from Pfizer and bioMerieux. Rita O. Oladele declares no competing interests. Timothy M. Rawson reports personal fees from bioMeriuex, Roche Diagnostics Ltd and Pfizer. Yohei Doi reports personal fees from Gilead Sciences, MSD, GSK, Shionogi, Meiji Seika Pharma, Moderna, bioMerieux, Chugai, FujiFilm, MSD and Eiken Chemical.

Figures

Fig. 1
Fig. 1
Main barriers to use of RDTs, derived from EWG semi-structured interviews. EWG expert working group, RDT rapid diagnostic test
Fig. 2
Fig. 2
The value of RDT use in ASPs to key stakeholders: hospitals, clinicians, patients, and society. AMS antimicrobial stewardship, ASP antimicrobial stewardship programme, RDT rapid diagnostic test
Fig. 3
Fig. 3
EWG perspectives on RDT use across the patient care pathway. EWG expert working group, HCP healthcare professional, RDT rapid diagnostic test
See this image and copyright information in PMC

References

    1. Beganovic M, McCreary EK, Mahoney MV, Dionne B, Green DA, Timbrook TT. Interplay between rapid diagnostic tests and antimicrobial stewardship programs among patients with bloodstream and other severe infections. J Appl Lab Med. 2019;3:601–616. - PubMed
    1. O’Neill J. Tackling Drug-resistant infections globally: final report and recommendations. 2016. https://amr-review.org/sites/default/files/160525_Final%20paper_with%20c.... Accessed 14 May 2022.
    1. World Health Organization. Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries: a WHO practical toolkit. 2019. https://apps.who.int/iris/handle/10665/329404. Accessed 18 May 2022. - PMC - PubMed
    1. Årdal C, Outterson K, Hoffman SJ, et al. International cooperation to improve access to and sustain effectiveness of antimicrobials. Lancet. 2016;387:296–307. - PubMed
    1. Miller MB, Atrzadeh F, Burnham CA, et al. Clinical utility of advanced microbiology testing tools. J Clin Microbiol. 2019;57:e00495–e519. - PMC - PubMed

LinkOut - more resources