Effect of Rapid Diagnosis of Influenza Virus Type A on the Emergency Department Management of Febrile Infants and Toddlers

Abstract

Rapid confirmation of influenza virus type A infection seems to decrease ancillary tests and antibiotic use in febrile infants and toddlers in the ED. A prospective study with a larger group is needed to confirm these findings.

Changes in trends and impact of testing for influenza in infants with fever <90 days of age

“…We also found that during the study period, antibiotic usage and admission rates decreased significantly in the study population. These findings are in agreement with previous reports showing that the introduction of rapid laboratory confirmation of influenza into the protocols for children with fever can substantially decrease the number of diagnostic tests performed, antibiotic prescriptions given, and hospitalizations …”

Practice Patterns of Pediatric Emergency Medicine Physicians Caring for Young Febrile Infants

“…[14][15][16] Despite the fact that current clinical care algorithms do not include rapid viral testing, the knowledge provided by rapid viral tests for RSV and influenza seems to influence physician decision making by decreasing ancillary tests and antibiotic use in young febrile infants seen in the ED. [17][18][19][20] Viral testing was performed in almost half of all infants presenting with fever in our study and, in agreement with previous studies, the incidence of SBI in those patients with a positive viral test was lower than those pati ents with a negative viral test. It was not possible to determine how, if at all, viral testing affected the decision making of the physicians in our study given its retrospective design.…”

Impact of PCR for respiratory viruses on antibiotic use: Theory and practice

“…Our results are in agreement with Doan et al 10 and Poehling et al, 12 who did not find a reduction in antibiotic prescription in children randomized to have rapid testing performed at the emergency department. Our results are in contrast with studies from Bonner et al, 9 Noyola and Demmler, 11 Sharma et al, 13 and Woo et al, 14 who found that physicians prescribed less antibiotics in patient groups tested with a rapid viral test. These studies were all performed at the emergency department or at pediatric wards, and not at the PICU, and assessed different age groups.…”