TY - JOUR
T1 - Association of the FilmArray meningitis/ encephalitis panel with clinical management
AU - Nabower, Aleisha M.
AU - Miller, Sydney
AU - Biewen, Benjamin
AU - Lyden, Elizabeth
AU - Goodrich, Nathaniel
AU - Miller, Alison
AU - Gollehon, Nathan
AU - Skar, Gwenn
AU - Snowden, Jessica
N1 - Publisher Copyright:
Copyright © 2019 by the American Academy of Pediatrics
PY - 2019
Y1 - 2019
N2 - OBJECTIVES: To determine the association of the use of the multiplex assay meningitis/ encephalitis panel with clinical management of suspected meningitis. METHODS: A cross-sectional study was conducted with children 0 to 18 years of age who received a lumbar puncture within 48 hours of admission for an infectious workup. Patient demographic and presenting information, laboratory studies, and medication administration were collected. The primary measure was length of stay (LOS) with secondary measures: time on antibiotics, time to narrowing antibiotics, and acyclovir doses. LOS and antibiotic times were stratified for outcomes occurring before 36 hours. Logistic regression analysis was used to account for potential confounding factors associated with both the primary and secondary outcomes. A value of P, .05 was considered statistically significant. RESULTS: Meningitis panel use was associated with a higher likelihood of a patient LOS,36 hours (P 5 .04; odds ratio 5 1.7; 95% confidence interval [CI]: 1.03–2.87), a time to narrowing antibiotics,36 hours (P 5 .008; odds ratio 5 1.89; 95% CI: 1.18–2.87), and doses of acyclovir (P, .001; incidence rate ratio 5 0.37; 95% CI: 0.26–0.53). When controlling for potential confounding factors, these associations persisted. CONCLUSIONS: Use of the meningitis panel was associated with a decreased LOS, time to narrowing of antibiotics, and fewer acyclovir doses. This likely is a result of the rapid turnaround time as compared with cerebrospinal fluid cultures. Additional studies to examine the outcomes related to this change in management are warranted.
AB - OBJECTIVES: To determine the association of the use of the multiplex assay meningitis/ encephalitis panel with clinical management of suspected meningitis. METHODS: A cross-sectional study was conducted with children 0 to 18 years of age who received a lumbar puncture within 48 hours of admission for an infectious workup. Patient demographic and presenting information, laboratory studies, and medication administration were collected. The primary measure was length of stay (LOS) with secondary measures: time on antibiotics, time to narrowing antibiotics, and acyclovir doses. LOS and antibiotic times were stratified for outcomes occurring before 36 hours. Logistic regression analysis was used to account for potential confounding factors associated with both the primary and secondary outcomes. A value of P, .05 was considered statistically significant. RESULTS: Meningitis panel use was associated with a higher likelihood of a patient LOS,36 hours (P 5 .04; odds ratio 5 1.7; 95% confidence interval [CI]: 1.03–2.87), a time to narrowing antibiotics,36 hours (P 5 .008; odds ratio 5 1.89; 95% CI: 1.18–2.87), and doses of acyclovir (P, .001; incidence rate ratio 5 0.37; 95% CI: 0.26–0.53). When controlling for potential confounding factors, these associations persisted. CONCLUSIONS: Use of the meningitis panel was associated with a decreased LOS, time to narrowing of antibiotics, and fewer acyclovir doses. This likely is a result of the rapid turnaround time as compared with cerebrospinal fluid cultures. Additional studies to examine the outcomes related to this change in management are warranted.
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U2 - 10.1542/hpeds.2019-0064
DO - 10.1542/hpeds.2019-0064
M3 - Article
C2 - 31511395
AN - SCOPUS:85078587631
SN - 2154-1663
VL - 9
SP - 763
EP - 769
JO - Hospital Pediatrics
JF - Hospital Pediatrics
IS - 10
ER -