English
Objective
The JUNO trial, a prespecified pilot phase of the JUPITER RCT (NCT05762302), evaluated the impact of MeMed BV® use on safe antibiotic prescribing.
Study Design
- A multicenter randomized controlled trial (RCT) was conducted. Patients with fever within 7 days, plus at least 1 respiratory symptom (cough, sputum production, dyspnea, or auscultation abnormality), and for whom the clinician intended to prescribe antibiotics were included.
- Patients were randomized 1:1 to the Standard Care arm (SC; no MeMed BV score) or the MeMed BV arm (MeMed BV result available, and the provider could change the decision to prescribe). Patients admitted for further care after randomization were excluded from the analysis.
Results
The analysis included 214 patients (106 patients in the SC arm and 108 in the MeMed BV arm).
How did testing with MeMed BV affect rates of antibiotic prescription? |
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For Viral infections:
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For Bacterial infections:
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Safety outcomes
- Reduced return visits: 3% of test group patients returned to ED/urgent care within 7 days vs. 8% with standard care
- Prevented hospitalizations: 0% hospitalizations in test group vs. 3% with standard care
- Improved safety profile: Targeted antibiotic approach proved at least as safe as standard care practices
Conclusions
The JUNO pilot study provided insights to improve the JUPITER RCT. The pilot phase was not powered to detect an effect in prescribing behavior between the two arms. However, patients in the MeMed BV arm with a viral score received proportionally fewer antibiotic prescriptions without an increase in return visits or hospitalization. Patients with a bacterial score received proportionally more antibiotic prescriptions with fewer return visits and hospitalizations as compared with the SC arm.
Reference:
Singer AJ, Hollander JE, Kean ER, et al. Effect of host-protein test (TRAIL/IP-10/CRP) on antibiotic prescription and emergency department or urgent care center return visits: The JUNO pilot randomized controlled trial. Acad Emerg Med. 2025;00:1-10. doi:10.1111/acem.70031
2025-14779
