TY - JOUR T1 - Do physicians use urinary pneumococcal antigen test (UPAT) appropriately? JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2495 AU - Vinod Palissery AU - Ajay Kamath AU - Catherine Tremlett Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2495.abstract N2 - Introduction: UPAT is a useful test to identify the pneumococcal aetiology of pneumonia. The specificity and sensitivity are high in moderate to severe pneumonia (MSP). British Thoracic Society (BTS) recommends this test only in MSP. But as this test has become more accessible it is being used inappropriately in non severe pneumonia, infective exacerbation of asthma and COPD. The most important use of the test is in modifying the antibiotic regimen according to the result. We did this study to look at the utility of the test and how it altered clinical management.Method: We conducted a retrospective analysis of medical records of all patients who had UPAT in a 6-month period between December 2007 and May 2008. The study was performed in a 1000 bed tertiary teaching hospital in United Kingdom. BTS CURB-65 scoring was used as a measure of severity of pneumonia.Results: One hundred and eighteen patients had the test in the 6-month study period but only 37 patients met criteria for moderate to severe pneumonia (MSP). Rest of the patients had non-severe pneumonia, infective exacerbation of asthma/COPD/Bronchiectasis. Ten patients had positive results (8.4 %); 13.5 % positive results were in MSP group and 6.1 % in the other group. Most common antibiotic regimen commenced in our institution was amoxicillin and clarithromycin (41%). Modification in antibiotic regimen guided by the results was done only in three patients.Conclusion: UPAT is used inappropriately and the test results are not effectively used in modifying management. ER -