[Urine antigen testing: Indication and contribution to the treatment of community-acquired pneumonia]

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Public Health

Background:

• Urinary antigen tests aid in diagnosing community-acquired pneumonia (CAP).
• Overprescription and unjustified use of these tests are concerns.
• The therapeutic benefits of urinary antigen tests are often limited.

Purpose of the Study:

• To evaluate the diagnostic utility and therapeutic impact of urinary antigen tests in CAP.
• To assess the clinical and epidemiological value of Legionella and Streptococcus pneumoniae urinary antigen tests.

Main Methods:

• Review of studies on urinary antigen test efficacy in CAP management.
• Analysis of cost-effectiveness and patient survival data compared to empirical therapy.
• Evaluation of specific indications for Legionella and Streptococcus pneumoniae urinary antigen tests.

Main Results:

• Appropriate antibiotic therapy guided by urinary antigen tests does not improve patient survival or cost-effectiveness versus empirical therapy.
• Caution is advised against reducing antibiotic therapy based solely on negative urinary antigen test results.
• Legionella urinary antigen tests are valuable for diagnosing legionellosis but require specific clinical contexts; Streptococcus pneumoniae tests are useful for epidemiological surveillance.

Conclusions:

• Urinary antigen tests provide rapid etiological diagnosis for CAP but have limited therapeutic impact.
• The clinical utility of Legionella and Streptococcus pneumoniae urinary antigen tests is context-dependent, primarily for specific diagnoses and surveillance.
• Optimizing the prescription of urinary antigen tests is crucial to avoid overuse and ensure appropriate clinical application.