Acute respiratory tract infections in southern Sri Lanka
Antibiotic overuse for ARTIs is common worldwide and is associated with unnecessary healthcare costs, increased adverse drug effects, and the growing global threat of antibiotic resistance. In low- or middle-income settings, antibiotic overuse for ARTIs can be even more pronounced due to factors such as limited access to laboratory testing. In southern Sri Lanka, we were able to document influenza seasonality over a 2-year period using a newer-generation rapid influenza test. Further comprehensive testing for ARTI etiology using a test that detects a broad panel of respiratory viruses is currently underway. In our study, the majority of patients (>80%) with ARTIs received antibiotic prescriptions, with most of these likely being unnecessary. Providing clinicians with access to positive rapid influenza test results was associated with a significant drop in antibiotic prescriptions. We are currently in the process of conductive a qualitative assessment of rapid diagnostic uptake and antibiotic prescribing practices, as well as a cost effectiveness assessment of rapid influenza testing. The ultimate goal is to leverage diagnostics to improve antibiotic stewardship for ARTIs in low- or middle-income settings.