Evaluating a rapid viral vs bacterial point of care test (CRP + MxA) to support diagnosis and appropriate antibiotic prescribing in Calderdale, West Yorkshire ICB (ID 621)
Calderdale Cares Partnership, NHS West Yorkshire Integrated Care Board
Abstract
Background
Respiratory infections are frequent primary care presentations, a leading cause of oral antibiotic prescriptions and many urgent care visits in the NHS. Because bacterial and viral respiratory tract infections often present with similar symptoms, misdiagnosis is frequent resulting in antibiotics being prescribed for suspected bacterial infection. Over 50% of this prescribing is deemed unnecessary1; a driver of antimicrobial resistance. While some cases are viral or self-limiting, some bacterial infections require immediate detection and antibiotic treatment to reduce morbidity.
Aim
Following a successful 2023/24 pilot2, the 2024/25 objective was to understand the patient impact of a rapid Point of Care Test (POCT) that distinguishes between viral and bacterial infections. This initiative aligns with NHS, PCRS, and UKHSA goals of early detection, accurate diagnosis and informed decision-making, ultimately reducing the burden of infectious diseases and antimicrobial resistance.
Methods
The FebriDx POCT (Lumos Diagnostics) was implemented across Acute Respiratory Infection (ARI) hubs in primary care. This finger-prick test was chosen for its portability, speedy results, and accuracy achieved by combining CRP (C-Reactive protein) with a viral biomarker MxA (Myxovirus resistance protein A). A retrospective patient survey yielded 1,186 responses from 4,500 tests (26% response rate).
Results
A total of 428/1186 (36%) patients would have attended A&E if the ARI hub appointment wasn’t available. Notably this proportion was higher in the patient cohort who had a test (40%). A total of 326/1186 (27%) patients received a test, of which 85% found the test useful. Many said it offered reassurance and helped guide treatment. Patients valued the test's speed and ease, many describing it as quick and painless.
Conclusions
A rapid, portable, finger-prick diagnostic test (CRP + MxA) in primary care was well-received by patients, provided reassurance and guided appropriate antibiotic use. By empowering frontline care, it aligns with the UK Government’s shift from “hospital to community” and “sickness to prevention,” offering a practical tool to fight AMR.
1. Chandra Deb L et al. Antibiotic Prescribing Practices. Open Forum Infect Dis. 2022 Jun 17;9(7):ofac302.
2. Fazlee M et al. Evaluating a rapid point of care test. UKHSA Conference. March 2025. ePoster Num: P-120.
Funding: This was a collaborative working project funded by Calderdale NHS Trust.
Conflicts of interest: None
The conference has been instigated and organised by PCRS. We are grateful to sponsors and exhibitors who have contributed funding towards this event in return for exhibition space. Neither sponsors or exhibitors have had any input into the agenda or the selection of speakers with the exception of any sponsored satellite symposia which are clearly indicated. View the full list of sponsors.
The conference social programme - dinner, drinks and disco - is not covered by sponsorship or exhibition fees.