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Point-of-care testing reduces antibiotic prescribing for adults with community-acquired pneumonia: a systematic
Wenshuai Ji1,2,3, Kai Xie1,2,3, Kang Zhang1,2,3
1Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
Objectives:
To evaluate the impact of point-of-care testing (POCT) on antibiotic prescribing and clinical outcomes in adult patients with community-acquired pneumonia (CAP) through a systematic review and meta-analysis.
Methods:
Web of Science, Scopus, Embase, PubMed, and Cochrane Library were searched for randomized controlled trials (RCTs). The final search was conducted on June 2025. Outcomes included both antibiotic-related and clinical outcomes. The meta-analysis was performed using Review Manager. The study was registered with PROSPERO (CRD420251035572).
Results:
Nine RCTs involving 2,899 participants were included. POCT significantly reduced the proportion of adult CAP patients receiving antibiotic prescriptions by 10% (RD = -0.10; 95% CI: -0.15 to -0.05, P < 0.0001) and shortened the duration of antibiotic treatment by 2.68 days (MD = -2.68; 95% CI: -4.41 to -0.95, P = 0.002). Available evidence suggests no signal of harm, although safety outcomes were reported in relatively few trials, such as the length of hospital stay (MD = -0.43; 95% CI: -1.41 to 0.54, P = 0.38). Sensitivity analyses confirmed the robustness of these findings.
Conclusion:
POCT may reduce antibiotic exposure in patients with CAP without compromising clinical outcomes. As diagnostic innovation plays an increasingly important role in combating antimicrobial resistance, POCT should be used selectively as an adjunct to clinical judgment.
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