RSV rapid antigen testing (Ag RDT) in primary care reduces inappropriate antibiotic prescribing

🦠 New JAMA Study: RSV Rapid Testing Cuts Unnecessary Antibiotic Use in Young Children A new JAMA Network Open investigation offers compelling evidence that RSV rapid antigen testing in primary care meaningfully reduces inappropriate antibiotic prescribing for infants and toddlers with viral lower respiratory tract infections. In a cohort of 256 children aged 9–36 months, researchers found that: • RSV-positive children were prescribed far fewer antibiotics than RSV-negative children. • Implementing RSV Ag RDTs reduced antibiotic use by 40–50% compared with matched untested cohorts. • When RSV was confirmed, the reduction was even stronger (RR as low as 0.33). • Importantly, reduced prescribing did not increase ED visits or hospitalizations, reinforcing the safety of test-guided management. This study reinforces what many clinicians have long suspected: rapid viral diagnostics are essential to antimicrobial stewardship, especially in community pediatrics, where diagnostic uncertainty often drives unnecessary antibiotic use. As RSV immunoprophylaxis expands and respiratory testing becomes more accessible, the combination of prevention + rapid diagnostics will reshape how pediatric VLRTIs are managed.

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