Views of Spanish primary care professionals on respiratory tract infection testing: a qualitative study

Respiratory tract infection tests are increasingly available in primary care and are expected to expand in the future. However, there is limited understanding of clinicians' views on their benefits and how to effectively integrate them into daily clinical practice.

The aim of this study was to explore healthcare professionals' views on using respiratory tract infection tests to safely reduce unnecessary antibiotic prescriptions for respiratory tract infections in primary care based on their experience in routine practice.

A qualitative study design was employed. Two focus group discussions were conducted.

These focus group discussions were conducted in February 2025, involving 18 Spanish primary care professionals, both experts and non-experts in rational antibiotic use and antimicrobial resistance. Data were audio-recorded or video-recorded, transcribed and analysed thematically.

Participants agreed that respiratory tract infection tests help optimise antibiotic prescriptions, reduce uncertainty, ensure the appropriate consumption of resources and guide treatment based on aetiology. While most professionals view microbiological tests and C-reactive protein testing as complementary, non-experts preferred microbiological tests. Professionals considered that patients value knowing the aetiology over the prognosis, supporting shared decision-making and addressing patients' demands more effectively. Concerns remain about using these tests as stand-alone tools and the medicalisation of self-limiting conditions. Other barriers mentioned included the high cost and time-consuming nature, the need for better professional training and the challenge of managing the increased workload associated with their use.

This study highlights how clinicians perceive respiratory tract infection tests to aid prescribing decisions amid uncertainty. Both positive and negative views were reported. Participants agreed that these tests optimise antibiotic prescriptions and guide treatment, but there are still important barriers to their implementation.