Outpatient Antibiotic Stewardship: A Growing Frontier—Combining Myxovirus Resistance Protein A With Other Biomarkers to Improve Antibiotic Use

Joseph, Patrick; Godofsky, Eliot

A rapid point-of-care test that measures both CRP and MxA is available in Europe and Canada, but not currently in the United States. Utilization results of the FebriDx test in outpatient clinical practice are impressively encouraging, including diagnostic accuracy and positive impact on appropriate antibiotic prescribing [9] . The 97% NPV reduces the clinician's fear of missing a serious bacterial infection and supports watchful waiting, while the ability to demonstrate tangible results at the office visit can relieve patient pressures for antibiotic prescriptions [9] . A recent survey estimates that 85% of US primary care clinicians currently use a rapid strep test and 60% use a rapid flu test, oftentimes in the same patient [71] . A rapid point-ofcare test utilizing detection of both MxA and CRP without any required ancillary reader equipment would likely reduce the need for rapid strep and flu testing and provide direct cost savings while reducing indirect costs related to the cost of unnecessary antibiotics themselves, adverse events, and potential resistance.