Inappropriate antibiotic prescriptions drive antimicrobial resistance. This study assessed the impact of diagnostic algorithms incorporating rapid diagnostic tests (RDTs) on clinical outcomes and antibiotic prescriptions compared with standard-of-care practices for acute febrile illness in Ghanaian children (6 months to <18 years). 1512 patients were randomized to an intervention (n=761) or control group (n=751). The intervention group showed an 11% relative risk reduction in antibiotic prescription (RR, 0.89; 95% CI, .79 to 1.01), with greater reductions in children under 5, non-malaria patients, and those with respiratory symptoms. Almost all participants had favorable outcomes. The combination of point-of-care diagnostics, algorithms, and communication training can reduce antibiotic prescriptions in primary healthcare settings.

Alexander Adjei, Vida Kukula, Clement Tetteh Narh, Selase Odopey, Emmanuel Arthur, Gabriel Odonkor, Michael Matey Mensah, Piero Olliaro, Philip Horgan, Sabine Dittrich, Catrin E Moore, Olawale Salami, Elizabeth Awini, Juvenal Nkeramahame, John Williams, Rita Baiden