The quality of evidence is downgraded by inconsistency (statistical heterogeneity).
A Cochrane review [Abstract] 1 included 5 studies with a total of 2 891 children and adult subjects (2 545 participants after adjusting for clustering). In 3 studies rapid tests were used in combination with a clinical scoring system, in 1 study, some physicians used rapid tests alone, while others used rapid tests in combination with a clinical scoring system, and in 1 study, rapid tests were used alone.
Rapid tests reduced prescribed antibiotics compared to management based on clinical grounds (481/1197 vs. 865/1348; RD−25%, 95% CI −31% to −18%, statistical heterogeneity I2 =62%; 5 studies, n=2 545), but did not reduce dispensed antibiotic treatments (156/445 vs. 197/455; RD −7%, 95% CI −17% to 2%, statistical heterogeneity, I2 =53%; 2 studies, n=900) compared to management based on clinical grounds.No difference between groups in complications attributed to the index infection were observed, but the evidence was very uncertain.There was no statistically significant difference in the number of participants in need of re-consultation by the end of follow-up between rapid test and control groups (OR 1.12, 95% CI 0.57 to 2.21, statistical heterogeneity, I2 =59%; 2 studies, n=1 161).
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