LAUSR

Prolonged turnaround time of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) test results may delay time to notification and treatment of test-positive patients and result in unnecessary antimicrobial use in test-negative patients. This quasi-experimental study evaluated the impact of NG/CT rapid diagnostic testing (RDT) in an urban emergency department (ED) on treatment appropriateness, time to notification, and cost. Patients tested in December 2013-January 2014 (traditional group, n=200) were compared with those in December 2014-January 2015 (RDT group, n=200). There was a significant increase in treatment appropriateness in the RDT group, 72.5% versus 60% (P=0.008) and time to results notification was significantly faster (median 17.4 versus 51.5hours, P=0.010). Availability of test result prior to discharge was associated with increased treatment appropriateness (odds ratio, 22.65 [95% confidence interval, 2.86-179.68]). The RDT would save approximately $37,000 annually. These results support the use of NG/CT RDT to expand antimicrobial stewardship efforts within the ED.