Potential utility of multiplex amplification respiratory viral panel testing in the management of acute respiratory infection in children: A retrospective analysis

Russell J. McCulloh, Sarah Andrea, Steven Reinert, Kimberle Chapin

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background. Multiplex real-time polymerase chain reaction respiratory viral panel (RVP) testing offers enhanced test performance characteristics compared with older testing methods. However, the impact of RVP testing on physician antimicrobial prescription practices remains unclear. Our objective was to assess the potential relationship of RVP testing to physician treatment practices for children hospitalized with acute respiratory illness (ARI). Methods. We performed a retrospective chart review of children hospitalized for ARI during peak prevalence of respiratory viral infections in 2009-2011. Demographics, diagnostic testing, antimicrobial use, and clinical outcomes were abstracted from the electronic medical record. Antimicrobial use was compared with RVP testing data. Results. A total of 1727 patients met inclusion criteria. Of these patients, 254 (14.7%) children who were hospitalized for ARI received oseltamivir and 856 (49.6%) children received antibiotics. More children who received oseltamivir were positive for influenza by RVP (76.9% vs 18.0%; P <.0001). Children who underwent RVP testing received antibiotics more often than those who were not tested (53.7% vs 46.0%; P =.001), but children with a positive RVP test result received antibiotics less often (51.6% vs 67.0%; P =.003). A total of 5.8% of children who were positive for a viral pathogen by RVP had antibiotics discontinued. Antibiotics were started in fewer children when RVP results were positive (10.9% vs 100.0%; P <.0001). Conclusions. Respiratory viral panel testing was associated with more appropriate oseltamivir use in children hospitalized with ARI. Physicians started antibiotics more often in children with a negative RVP test result and occasionally discontinued antibiotics in children diagnosed with a viral pathogen. These results suggest that RVP testing may enhance physician decision-making when prescribing antimicrobials in children hospitalized with ARI.

Original languageEnglish (US)
Article numberpit073
Pages (from-to)146-153
Number of pages8
JournalJournal of the Pediatric Infectious Diseases Society
Volume3
Issue number2
DOIs
StatePublished - 2014

Keywords

  • Antimicrobial stewardship
  • Respiratory viral panel
  • Virology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases

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