Contribution of a rapid influenza diagnostic test to manage hospitalized patients with suspected influenza

More targeted use of oseltamivir and in-hospital isolation facilities after implementation of a multifaceted strategy including a rapid molecular diagnostic panel for respiratory viruses in immunocompromised adult patients

“…The lack of significant results on these outcomes might be due to insufficient power of our study, and due to our vulnerable, immunocompromised patient population, in whom withholding or discontinuing antibiotic treatment is not according to (inter)national recommendations. Nevertheless, these results are in line with most former studies, mostly among immunocompetent patients, that also showed no reduction in antibiotic prescriptions [11,14,19,22,24,41,42]. Only two observational studies [15,16] showed a significant effect, but both validity and generalizability were problematic in these studies due to inadequate adjustment for potential confounders and specific patient selection [15].…”

“…However, current evidence on the effect of implementation of rapid molecular testing on clinical outcomes and hospital resource use is heterogeneous and inconclusive. Most studies only focus on immunocompetent patients, do not specifically address the viral respiratory season, are of low quality due to their design or lack of proper adjustment for potential confounders [13][14][15][16][17][18][19][20][21][22], whereas randomized studies [11,[23][24][25][26] evaluating effects within a research setting with perfect implementation of diagnostic assays, may lead to over-optimistic results.…”

Clinical decision making in the emergency department setting using rapid PCR: Results of the CLADE study group

“…Our experience demonstrates that providing the diagnosis nearer to patient presentation continues to be an actionable event that impacts medical management for 61% of cases. The greatest impact on empiric medical management affected antimicrobial stewardship processes, highlighting the relationship between rapid diagnostics and appropriate antibiotic and antiviral prescribing previously described [10,5]. As developments in small molecule and monoclonal therapies for influenza infection grow [21][22][23][24], the importance of access to rapid, sensitive diagnostics capable of guiding antiviral prescribing and treatment decisions will become important, a finding supported by our experience.…”

Contribution of the FilmArray Respiratory Panel in the management of adult and pediatric patients attending the emergency room during 2015–2016 influenza epidemics: An interventional study

“…What seems to be agreed upon is that results of molecular tests should be delivered rapidly in the course of patient management. The availability of results in the emergency room (ER) would most likely help avoid antibiotic use and ancillary test prescription, improve antiviral prescription and shorten length of stay in the ward by facilitating discharge of patients or cohorting of hospitalized patients, namely for influenza viruses (Xu et al, 2013;Rappo et al, 2016;Busson et al, 2017). Selecting the population for which the test should be applied also seems of great importance to increase cost-effectiveness (Boeckh, 2008;Vallières and Renaud, 2013).…”