The effect of rapid respiratory viral diagnostic testing on antibiotic use in a children's hospital

Carrie L. Byington, Heidi Castillo, Kris Gerber, Judy A. Daly, Laurie A. Brimley, Susan Adams, John Christenson, Andrew T. Pavia

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Background: Acute viral respiratory disease is the most common reason for pediatric hospitalization in the United States. Viral illnesses may be mistaken for bacterial infection, and antibiotic therapy may be prescribed. Over-prescribing of antimicrobials for viral illness is a factor contributing to increasing antimicrobial resistance among bacterial pathogens encountered in pediatrics. Objectives To determine if the availability of a rapid diagnostic test for respiratory viruses would affect antibiotic use in a children's hospital. Design: Retrospective medical record review. Setting: A 232-bed urban children's hospital. Participants: All hospitalized infants and children who underwent rapid testing (SimulFluor Respiratory Screen; Chemicon International Inc, Temecula, Calif) for respiratory viruses by direct fluorescent assay (DFA) during 2 successive winter seasons. Main Outcome Measures: Rates of antibiotic prescribing in DFA-positive and DFA-negative patients during the 2 study periods. Results: During the first winter season, DFA-positive patients had fewer days using intravenous antibiotics (2.4 vs 4, P=.04), fewer days using oral antibiotics (0.25 vs 2.5, P=.04), and fewer discharge prescriptions for oral antibiotics (37% vs 52%, P=.02) when compared with DFA-negative patients. Intravenous antibiotics were initiated less often for DFA-positive patients during the second winter season than during the first (26% vs 44%, P=.008). Conclusions: Direct fluorescent assay testing was associated with a decrease in inappropriate antibiotic use. The availability of rapid viral diagnostics is an important tool for decreasing antibiotic prescribing in pediatric patients.

Original languageEnglish
Pages (from-to)1230-1234
Number of pages5
JournalArchives of Pediatrics and Adolescent Medicine
Volume156
Issue number12
StatePublished - Dec 1 2002

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Anti-Bacterial Agents
Pediatrics
Inappropriate Prescribing
Viruses
Hospitalized Child
Urban Hospitals
Virus Diseases
Bacterial Infections
Routine Diagnostic Tests
Medical Records
Prescriptions
Hospitalization
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Byington, C. L., Castillo, H., Gerber, K., Daly, J. A., Brimley, L. A., Adams, S., ... Pavia, A. T. (2002). The effect of rapid respiratory viral diagnostic testing on antibiotic use in a children's hospital. Archives of Pediatrics and Adolescent Medicine, 156(12), 1230-1234.

The effect of rapid respiratory viral diagnostic testing on antibiotic use in a children's hospital. / Byington, Carrie L.; Castillo, Heidi; Gerber, Kris; Daly, Judy A.; Brimley, Laurie A.; Adams, Susan; Christenson, John; Pavia, Andrew T.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 156, No. 12, 01.12.2002, p. 1230-1234.

Research output: Contribution to journalArticle

Byington, CL, Castillo, H, Gerber, K, Daly, JA, Brimley, LA, Adams, S, Christenson, J & Pavia, AT 2002, 'The effect of rapid respiratory viral diagnostic testing on antibiotic use in a children's hospital', Archives of Pediatrics and Adolescent Medicine, vol. 156, no. 12, pp. 1230-1234.
Byington CL, Castillo H, Gerber K, Daly JA, Brimley LA, Adams S et al. The effect of rapid respiratory viral diagnostic testing on antibiotic use in a children's hospital. Archives of Pediatrics and Adolescent Medicine. 2002 Dec 1;156(12):1230-1234.
Byington, Carrie L. ; Castillo, Heidi ; Gerber, Kris ; Daly, Judy A. ; Brimley, Laurie A. ; Adams, Susan ; Christenson, John ; Pavia, Andrew T. / The effect of rapid respiratory viral diagnostic testing on antibiotic use in a children's hospital. In: Archives of Pediatrics and Adolescent Medicine. 2002 ; Vol. 156, No. 12. pp. 1230-1234.
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