A positive pneumococcal urinary antigen test promotes narrow spectrum antibiotic use in patients with non-invasive pneumococcal pneumonia.

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A positive pneumococcal urinary antigen test promotes narrow spectrum antibiotic use in patients with non-invasive pneumococcal pneumonia.

Diagn Microbiol Infect Dis. 2019 Oct 05;:114897

Authors: Banks R, Zappernick T, Wilson B, Perez F, Jump RLP

Abstract
BACKGROUND: We compared changes in antibiotics in patients diagnosed with noninvasive pneumococcal pneumonia (NPP) by pneumoccocal urinary antigen tests or respiratory cultures.
METHODS: We compared patients diagnosed by pneumococcal urinary antigen tests or respiratory cultures that grew Streptococcus pneumoniae. We assessed the time from sample receipt to final result and antibiotic regimens, including an Antibiotic Spectrum Index (ASI).
RESULTS: Seventy-two cases of NPP were diagnosed by pneumococcal urinary antigen and 87 by respiratory cultures, with a median time from sample receipt to final result of 0.21 days (interquartile range (IQR) 0.17-1.17) and 3.21 days (IQR 3.17-4.21 days), respectively. Among 123 cases without antibiotic allergies, between days 0 and 2, the ASI decreased in 36% (18/50) of cases diagnosed by urinary antigen compared to 10% (7/73) of cases diagnosed by respiratory culture (P < 0.01).
CONCLUSIONS: Positive pneumococcal urinary antigen tests lead to early deescalation of antibiotics more frequently than respiratory cultures.

PMID: 31740170 [PubMed - as supplied by publisher]