Rapid result tests will help ensure patients get antibiotics when needed

People with suspected respiratory infections can undergo a simple test at their GP practice to help determine whether they need antibiotics.

The new project, which is being trialled across several GP practices in Swansea Bay, is hoped to ensure patients only have antibiotics when they need them.

They will be able to undergo a finger pinprick test at their surgery, with the result provided within minutes.

Pictured: Ty’r Felin Surgery GP partner Dr James Kerrigan and practice nurse Charlotte Rimmer with the machine.

The test helps to guide clinicians on whether antibiotics are needed, for example if the result is high, or not if the result is low.

Reducing the amount of unnecessary antibiotics prescribed can help to reduce the risk of antimicrobial resistance, which can make some infections more difficult to treat.

It also avoids some of the unpleasant and harmful side effects that can come with antibiotic treatments.

Dr Charlotte Jones is a GP partner at Uplands and Mumbles Surgery and the health board’s clinical lead for antimicrobial stewardship.

She said: “We have been doing a lot of work within primary care to make sure we are only giving antibiotics where they are needed, that the benefits for the patients are going to be seen and that we are going to minimise any potential side effects or harm to patients.

“We have also been looking at the type of antibiotics we are prescribing and the length of course, to make sure patients have long enough for their infection but not too long.

“We are going to use the finger pinprick test for patients with a suspected chest infection or who have chronic bronchitis or emphysema, linked to COPD, who may have an infection on top.

“Whoever speaks to the patient, either on the phone or in the practice, can offer them a test if they feel they may need antibiotics based on their symptoms or because of the examination findings they have had.

“The patient will then have the test at the practice, which takes a few minutes.”

Swansea Bay’s Local Cluster Collaboratives (LCCs) have pooled funding together to provide the project throughout the health board area.

Wherever possible, clusters aim to provide care in the community meaning patients won’t need to travel to hospitals or clinics.

Being able to offer the tests in GP practices supports this by helping to bring care closer to home for patients.

Eleven practices spread across Swansea and Neath Port Talbot are taking part to be able to assess the impact of the tests in different areas.

“It’s not just of benefit to the clinician but also the patient,” Dr Jones added.

“We can explain to them how the test helps us know whether antibiotics are likely to benefit their symptoms.

“It’s not about denying people treatment, it’s about making sure they get the right treatment at the right time, as well as understanding more about when antibiotics should be used or not.

“We are going to ask patients about their experience of having the test done to help us decide if it is a helpful test to offer in practices.

“We will also be asking the practices for feedback, as well as looking at data to see if prescribing patterns have shifted and if it’s helping clinicians.”

Julie Harris, Swansea Bay consultant antimicrobial pharmacist, said a rapid test result would help tackle the growing issue of antimicrobial resistance.

“This is a really important project,” she said.

“We are seeing an increase in infections in patients who are resistant to antibiotics and so are much more difficult to treat.

“Safely reducing the amount of antibiotics we use is the best way to try and combat this growing problem of antimicrobial resistance.

“Having this test with rapid results that helps clinicians identify patients with respiratory symptoms who do need antibiotics and spare them in those who won’t benefit from them, will really help with this."

Pictured: Dr Charlotte Jones with Andrew Griffiths, the health board’s Head of Cluster Development and Planning.

Dr James Kerrigan, a GP partner at Ty’r Felin Surgery in Gorseinon and Llwchwr Local Cluster Collaborative lead, has had experience of using the tests within his practice since before the pandemic.

He said: “After an initial telephone assessment we book the patient in for an appointment with one of our healthcare assistants and they have the test before their GP appointment, along with some basic clinical observations.

“By the time they come to see the clinician, the result is already available so it can aid the consultation.

“Being able to get the results so quickly potentially changes our management decisions, which will hopefully reduce our unnecessary antibiotic prescribing as a result.

“The patients really appreciate it. They value being able to come in and get the results straight away.”

The project will run for several months. It will be evaluated early next year to understand if it has had a positive impact on reducing unnecessary antibiotic prescribing and supported patient understanding on when antibiotics are useful.

Dr Jones said: “We are excited to see if the test is going to prove to be useful for patients, as well as for the practices and clinicians.”

Andrew Griffiths, the health board’s Head of Cluster Development and Planning, said: “The establishment of this project has been a real team effort from a range of different teams across the clusters and wider health board.

“Project coordination, training, distribution, logistics, GP and pharmacy advice all came together to develop a project that GP colleagues in our pilot practices have been able to embrace and implement.

“I am really pleased to have seen all of their efforts come to fruition and look forward to seeing the benefits for our population.”