Cepheid’s point-of-care molecular vaginitis assay improved diagnostic accuracy in a randomized clinical study, driving more appropriate treatment at the first visit. In work from the University of Pittsburgh Medical Center’s Magee-Womens Hospital, standard-of-care testing resulted in correct treatment only 51.9% of the time, compared with 89.6% when clinicians received results from a 60-minute in-office Cepheid Xpert Xpress MVP panel. The study assessed concordance using a true positive definition based on molecular comparator PCR from the BD Max Vaginal Panel. Among 276 participants, the molecular workflow reduced overtreatment: when molecular testing was negative for all three targeted conditions, inappropriately treating with antifungals or antibiotics occurred in 50% of the standard-care group versus 27.1% in the point-of-care arm. For biotech and med-tech developers, the results highlight the tradeoff between faster testing and clinical workflow adoption. It also underscores that point-of-care molecular assays may influence antimicrobial stewardship by decreasing decisions based on symptoms alone.