Re: Impact of a Rapid Point of Care Test for Influenza on Guideline Consistent Care and Antibiotic Use
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* Sora Yasri
* Viroj Wiwanitkit

*To the Editor:* Dear Editor, we read the publication on “Impact of a Rapid Point of Care Test for Influenza on Guideline Consistent Care and Antibiotic Use” with a great interest.1 Dale concluded that, “independent of test outcome, patients who received the test were more likely to receive an antiviral and less likely to receive an antibiotic or have a return visit within 2 weeks.”1 We would like to share ideas on this report. In our setting in tropical Indochina, influenza is very common and the diagnosis is usually primarily done by clinical decision. In primary health care center, the PCR point of care testing is usually not available and the cost of the test is considered high and not affordable. Most patients are examined and if there is any suspicious clinical feature viral infection, the anti-influenza drug might be used. This practice might result in unnecessary use of antiviral drug but it is better than waiting for a very long time for getting the confirmation of influenza test result from referring referencing laboratory. Regardless of final diagnosis, the patients usually inquire for getting antiviral drug.2 Nevertheless, another important problem is the effectiveness of antiviral drug due to the problem of drug resistance.2 How to implement the low cost point of care PCR test for influenza is usually a big question. To serve the need in primary health care center, a cost-effective point of care test should be searched for.

## Notes

*   To see this article online, please go to: [http://jabfm.org/content/32/4/000.full](http://jabfm.org/content/32/4/000.full).

*   The above letter was referred to the author of the article in question, who offers the following reply.

## References

1.  1.Dale AP, Ebell M, McKay B, et al. Impact of a rapid point of care test for influenza on guideline consistent care and antibiotic USE. J Am Board Fam Med 2019;32;226–233.
    
    [Abstract/FREE Full Text](http://www.jabfm.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToiamFiZnAiO3M6NToicmVzaWQiO3M6ODoiMzIvMi8yMjYiO3M6NDoiYXRvbSI7czoyMjoiL2phYmZwLzMyLzQvNjQxLjEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  2.Wiwanitkit V. Rates and effectiveness of antiviral use among hospitalized influenza patients. Expert Rev Anti Infect Ther 2015;13:835–842.