Antimicrobial stewardship in outpatient settings: Impact of point-of-care diagnostics.

Background: Inappropriate antibiotic use in outpatient settings is a major contributor to antimicrobial resistance, often driven by diagnostic uncertainty and patient expectations. Objective: To evaluate the impact of point-of-care diagnostics on antimicrobial stewardship in outpatient settings. Methods: This was a cross-sectional analytical study conducted at Department of Cardiology Armed Forces Institute of Cardiology & National Institute of Heart Diseases (AFIC&NIHD) Rawalpindi from April 2025 to April 2025 including 210 patients presenting to outpatient clinics to evaluate the impact of point-of-care diagnostics (POCD) on antimicrobial stewardship practices. Results: Antibiotic prescribing was significantly lower in the POCD group (47.3% vs 78.0%; p<0.001), with a marked reduction in inappropriate prescriptions (7.3% vs 40.0%; p<0.001). Guideline adherence was higher in the POCD group (78.2% vs 52.0%; p<0.001). POCD demonstrated high diagnostic accuracy (85.2%), with sensitivity of 88.5% and specificity of 82.3%. Clinical outcomes were comparable, with symptom resolution rates of 83.6% vs 74.0%, while revisit rates were significantly lower in the POCD group (12.7% vs 26.0%; p=0.012). Patient satisfaction was higher with POCD (4.3 ± 0.6 vs 3.5 ± 0.8; p<0.001). Conclusion: Point-ofcare diagnostics significantly improve antimicrobial stewardship by reducing inappropriate use of antibiotics, enhancing guideline adherence, and improving patient satisfaction without compromising clinical outcomes.

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