Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department

Abstract

Current evidence is insufficient, although promising, to support routine rapid viral testing as a means to reduce antibiotic use in pediatric EDs. Results suggest that rapid viral testing may be beneficial but are not statistically significant due to lack of power. A large trial addressing these outcome measures is needed.

Effect of the Influenza Virus Rapid Antigen Test on a Physician's Decision to Prescribe Antibiotics and on Patient Length of Stay in the Emergency Department

“…In contrast to a large meta-analysis of pediatric ILI patients, which showed that IVRAT had no effect on antibiotic prescription to ILI patients [14], we found that IVRAT reduced the number of antibiotic prescriptions issued to influenza patients who were discharged home from the ED. The design of the present study is different from that of other studies that compared data from IVRAT-positive and IVRAT-negative patients [13], or compared data from patients in whom IVRAT was performed with those from patients in whom IVRAT was not performed during the same influenza season [11].…”

Effect of the Influenza Virus Rapid Antigen Test on a Physician's Decision to Prescribe Antibiotics and on Patient Length of Stay in the Emergency Department

“…In contrast to a large meta-analysis of pediatric ILI patients, which showed that IVRAT had no effect on antibiotic prescription to ILI patients [14], we found that IVRAT reduced the number of antibiotic prescriptions issued to influenza patients who were discharged home from the ED. The design of the present study is different from that of other studies that compared data from IVRAT-positive and IVRAT-negative patients [13], or compared data from patients in whom IVRAT was performed with those from patients in whom IVRAT was not performed during the same influenza season [11].…”

Benefits and drawbacks of molecular techniques for diagnosis of viral respiratory infections. Experience with two multiplex PCR assays

“…For AdV, isolation in cell cultures is usually required because of the poor sensitivity of IF and the number of AdV isolates coincided with those detected by molecular methods. These findings coincided with the experience of our group over the last two decades and have been reported by other authors [Dunn et al, 2004;Mahony, 2008;Doan et al, 2012;Cho et al, 2013].…”

The impact of rapid molecular diagnostic testing for respiratory viruses on outcomes for emergency department patients

“…Reports on the effect of rapid influenza virus testing and LOS have been conflicting. While evidence for an association between rapid testing and shorter overall inpatient LOS has been reported, findings regarding ED LOS are inconsistent . For example, a Cochrane review based on three randomised controlled trials did not find a statistically significant association of rapid viral diagnosis with lower mean ED LOS .…”

“…While evidence for an association between rapid testing and shorter overall inpatient LOS has been reported, findings regarding ED LOS are inconsistent . For example, a Cochrane review based on three randomised controlled trials did not find a statistically significant association of rapid viral diagnosis with lower mean ED LOS . In a study in children, ED LOS was actually 26 minutes longer with rapid PCR; inpatient LOS did not differ between the two groups, but was significantly shorter when the analysis was limited to patients with positive test results …”

Effect of the Influenza Virus Rapid Antigen Test on a Physician's Decision to Prescribe Antibiotics and on Patient Length of Stay in the Emergency Department

“…In contrast to a large meta-analysis of pediatric ILI patients, which showed that IVRAT had no effect on antibiotic prescription to ILI patients [14], we found that IVRAT reduced the number of antibiotic prescriptions issued to influenza patients who were discharged home from the ED. The design of the present study is different from that of other studies that compared data from IVRAT-positive and IVRAT-negative patients [13], or compared data from patients in whom IVRAT was performed with those from patients in whom IVRAT was not performed during the same influenza season [11].…”

Benefits and drawbacks of molecular techniques for diagnosis of viral respiratory infections. Experience with two multiplex PCR assays

“…For AdV, isolation in cell cultures is usually required because of the poor sensitivity of IF and the number of AdV isolates coincided with those detected by molecular methods. These findings coincided with the experience of our group over the last two decades and have been reported by other authors [Dunn et al, 2004;Mahony, 2008;Doan et al, 2012;Cho et al, 2013].…”

The impact of rapid molecular diagnostic testing for respiratory viruses on outcomes for emergency department patients

“…Reports on the effect of rapid influenza virus testing and LOS have been conflicting. While evidence for an association between rapid testing and shorter overall inpatient LOS has been reported, findings regarding ED LOS are inconsistent . For example, a Cochrane review based on three randomised controlled trials did not find a statistically significant association of rapid viral diagnosis with lower mean ED LOS .…”

“…While evidence for an association between rapid testing and shorter overall inpatient LOS has been reported, findings regarding ED LOS are inconsistent . For example, a Cochrane review based on three randomised controlled trials did not find a statistically significant association of rapid viral diagnosis with lower mean ED LOS . In a study in children, ED LOS was actually 26 minutes longer with rapid PCR; inpatient LOS did not differ between the two groups, but was significantly shorter when the analysis was limited to patients with positive test results …”

Effect of the Influenza Virus Rapid Antigen Test on a Physician's Decision to Prescribe Antibiotics and on Patient Length of Stay in the Emergency Department

“…In contrast to a large meta-analysis of pediatric ILI patients, which showed that IVRAT had no effect on antibiotic prescription to ILI patients [14], we found that IVRAT reduced the number of antibiotic prescriptions issued to influenza patients who were discharged home from the ED. The design of the present study is different from that of other studies that compared data from IVRAT-positive and IVRAT-negative patients [13], or compared data from patients in whom IVRAT was performed with those from patients in whom IVRAT was not performed during the same influenza season [11].…”

Benefits and drawbacks of molecular techniques for diagnosis of viral respiratory infections. Experience with two multiplex PCR assays

“…For AdV, isolation in cell cultures is usually required because of the poor sensitivity of IF and the number of AdV isolates coincided with those detected by molecular methods. These findings coincided with the experience of our group over the last two decades and have been reported by other authors [Dunn et al, 2004;Mahony, 2008;Doan et al, 2012;Cho et al, 2013].…”

The impact of rapid molecular diagnostic testing for respiratory viruses on outcomes for emergency department patients

“…Reports on the effect of rapid influenza virus testing and LOS have been conflicting. While evidence for an association between rapid testing and shorter overall inpatient LOS has been reported, findings regarding ED LOS are inconsistent . For example, a Cochrane review based on three randomised controlled trials did not find a statistically significant association of rapid viral diagnosis with lower mean ED LOS .…”

“…While evidence for an association between rapid testing and shorter overall inpatient LOS has been reported, findings regarding ED LOS are inconsistent . For example, a Cochrane review based on three randomised controlled trials did not find a statistically significant association of rapid viral diagnosis with lower mean ED LOS . In a study in children, ED LOS was actually 26 minutes longer with rapid PCR; inpatient LOS did not differ between the two groups, but was significantly shorter when the analysis was limited to patients with positive test results …”