Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis

Background: Molecular point-of-care testing (mPOCT) offers rapid identification of respiratory pathogens, but its impact on antibiotic use and patient outcomes remains uncertain. We aimed to comprehensively evaluate the effects of mPOCT on antibiotic use and major clinical outcomes in patients prese...

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Authors: Li, Qinyuan, Zhou, Qi, Fan, Jiangbo, Feng, Xifeng, Lai, Honghao, Chen, Yaolong, Ye, Zhikang, Song, Fujian, Liu, Jiao, Chen, Dechang, Kang, Rui, Tang, Daolin, Teboul, Jean-Louis, Timsit, Jean-Francois, Torres Martí, Antoni, De Waele, Jan J., Carratalà, Jordi, Jiang, Jianxin, Luo, Zhengxiu, Zeng, Ling
Format: article
Status:Published version
Publication Date:2026
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:dnet:recercat____::e04ee4147bce701fc2b855844cb75989
Online Access:https://hdl.handle.net/2445/229581
Access Level:Open access
Keyword:Metaanàlisi
Infeccions respiratòries
Meta-analysis
Respiratory infections
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spelling Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysisLi, QinyuanZhou, QiFan, JiangboFeng, XifengLai, HonghaoChen, YaolongYe, ZhikangSong, FujianLiu, JiaoChen, DechangKang, RuiTang, DaolinTeboul, Jean-LouisTimsit, Jean-FrancoisTorres Martí, AntoniDe Waele, Jan J.Carratalà, JordiJiang, JianxinLuo, ZhengxiuZeng, LingMetaanàlisiInfeccions respiratòriesMeta-analysisRespiratory infectionsBackground: Molecular point-of-care testing (mPOCT) offers rapid identification of respiratory pathogens, but its impact on antibiotic use and patient outcomes remains uncertain. We aimed to comprehensively evaluate the effects of mPOCT on antibiotic use and major clinical outcomes in patients presenting with acute respiratory tract infections (ARTIs). Methods: We searched MEDLINE, Embase, Web of Science, CENTRAL, CNKI, and Wanfang Data from inception to July 1, 2025, for randomised controlled trials (RCTs) evaluating mPOCT for patients presenting with ARTIs (PROSPERO CRD420251069333). The primary outcome was antibiotic use, assessed using pooled risk ratio (RR) with random-effects models. Risk of bias and certainty of evidence were assessed using the Risk Of Bias instrument for Use in SysTematic reviews-for Randomised Controlled Trials (ROBUST-RCT) and core Grading of Recommendations, Assessment, Development and Evaluation (GRADE), respectively. Findings: We included 25 RCTs involving 12,638 patients, of whom 61.0% were adults. Overall, mPOCT probably had little to no important effect on antibiotic use (RR 0.95, 95% CI 0.90–1.00; moderate certainty) or treatment duration (mean difference −0.44 days, 95% CI −0.98 to 0.09; moderate certainty). In adults, high-certainty evidence showed no effect on antibiotic use (RR 1.00, 95% CI 0.98–1.02), whereas in children, low-certainty evidence suggested a potential reduction (RR 0.79, 95% CI 0.65–0.97). Although mPOCT increased appropriate antibiotic prescribing (RR 2.07, 95% CI 1.55–2.77; moderate certainty), it did not affect 30-day mortality (RR 0.97, 95% CI 0.82–1.15; high certainty) and intensive care unit admission (RR 0.90, 95% CI 0.65–1.25; high certainty). Interpretation: Moderate to high certainty evidence suggests that mPOCT does not meaningfully reduce overall antibiotic use or improve patient outcomes, particularly in adults, despite enhancing prescribing appropriateness. Routine use of mPOCT for adults with ARTIs is therefore not supported. Funding: National Natural Science Foundation of China, the Postdoctoral Science Foundation, the Chongqing Municipality Joint Science and Health Major Medical Research Project, Outstanding Youth in Science and Technology, the Chongqing Youth Talent Fund, and the Research Foundation Flanders.Elsevier2026202620262026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion15 p.application/pdfhttps://hdl.handle.net/2445/229581Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1016/j.eclinm.2026.103799eClinicalMedicine, 2026, vol. 92https://doi.org/10.1016/j.eclinm.2026.103799cc-by-nc-nd (c) Li, Q. et al., 2026http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:dnet:recercat____::e04ee4147bce701fc2b855844cb759892026-05-29T05:05:01Z
dc.title.none.fl_str_mv Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
title Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
spellingShingle Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
Li, Qinyuan
Metaanàlisi
Infeccions respiratòries
Meta-analysis
Respiratory infections
title_short Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
title_full Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
title_fullStr Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
title_full_unstemmed Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
title_sort Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
dc.creator.none.fl_str_mv Li, Qinyuan
Zhou, Qi
Fan, Jiangbo
Feng, Xifeng
Lai, Honghao
Chen, Yaolong
Ye, Zhikang
Song, Fujian
Liu, Jiao
Chen, Dechang
Kang, Rui
Tang, Daolin
Teboul, Jean-Louis
Timsit, Jean-Francois
Torres Martí, Antoni
De Waele, Jan J.
Carratalà, Jordi
Jiang, Jianxin
Luo, Zhengxiu
Zeng, Ling
author Li, Qinyuan
author_facet Li, Qinyuan
Zhou, Qi
Fan, Jiangbo
Feng, Xifeng
Lai, Honghao
Chen, Yaolong
Ye, Zhikang
Song, Fujian
Liu, Jiao
Chen, Dechang
Kang, Rui
Tang, Daolin
Teboul, Jean-Louis
Timsit, Jean-Francois
Torres Martí, Antoni
De Waele, Jan J.
Carratalà, Jordi
Jiang, Jianxin
Luo, Zhengxiu
Zeng, Ling
author_role author
author2 Zhou, Qi
Fan, Jiangbo
Feng, Xifeng
Lai, Honghao
Chen, Yaolong
Ye, Zhikang
Song, Fujian
Liu, Jiao
Chen, Dechang
Kang, Rui
Tang, Daolin
Teboul, Jean-Louis
Timsit, Jean-Francois
Torres Martí, Antoni
De Waele, Jan J.
Carratalà, Jordi
Jiang, Jianxin
Luo, Zhengxiu
Zeng, Ling
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Metaanàlisi
Infeccions respiratòries
Meta-analysis
Respiratory infections
topic Metaanàlisi
Infeccions respiratòries
Meta-analysis
Respiratory infections
description Background: Molecular point-of-care testing (mPOCT) offers rapid identification of respiratory pathogens, but its impact on antibiotic use and patient outcomes remains uncertain. We aimed to comprehensively evaluate the effects of mPOCT on antibiotic use and major clinical outcomes in patients presenting with acute respiratory tract infections (ARTIs). Methods: We searched MEDLINE, Embase, Web of Science, CENTRAL, CNKI, and Wanfang Data from inception to July 1, 2025, for randomised controlled trials (RCTs) evaluating mPOCT for patients presenting with ARTIs (PROSPERO CRD420251069333). The primary outcome was antibiotic use, assessed using pooled risk ratio (RR) with random-effects models. Risk of bias and certainty of evidence were assessed using the Risk Of Bias instrument for Use in SysTematic reviews-for Randomised Controlled Trials (ROBUST-RCT) and core Grading of Recommendations, Assessment, Development and Evaluation (GRADE), respectively. Findings: We included 25 RCTs involving 12,638 patients, of whom 61.0% were adults. Overall, mPOCT probably had little to no important effect on antibiotic use (RR 0.95, 95% CI 0.90–1.00; moderate certainty) or treatment duration (mean difference −0.44 days, 95% CI −0.98 to 0.09; moderate certainty). In adults, high-certainty evidence showed no effect on antibiotic use (RR 1.00, 95% CI 0.98–1.02), whereas in children, low-certainty evidence suggested a potential reduction (RR 0.79, 95% CI 0.65–0.97). Although mPOCT increased appropriate antibiotic prescribing (RR 2.07, 95% CI 1.55–2.77; moderate certainty), it did not affect 30-day mortality (RR 0.97, 95% CI 0.82–1.15; high certainty) and intensive care unit admission (RR 0.90, 95% CI 0.65–1.25; high certainty). Interpretation: Moderate to high certainty evidence suggests that mPOCT does not meaningfully reduce overall antibiotic use or improve patient outcomes, particularly in adults, despite enhancing prescribing appropriateness. Routine use of mPOCT for adults with ARTIs is therefore not supported. Funding: National Natural Science Foundation of China, the Postdoctoral Science Foundation, the Chongqing Municipality Joint Science and Health Major Medical Research Project, Outstanding Youth in Science and Technology, the Chongqing Youth Talent Fund, and the Research Foundation Flanders.
publishDate 2026
dc.date.none.fl_str_mv 2026
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/229581
url https://hdl.handle.net/2445/229581
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.eclinm.2026.103799
eClinicalMedicine, 2026, vol. 92
https://doi.org/10.1016/j.eclinm.2026.103799
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Li, Q. et al., 2026
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Li, Q. et al., 2026
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 15 p.
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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