Rapid Viral Testing and Antibiotic Prescription in Febrile Children With Respiratory Symptoms Visiting Emergency Departments in Europe



Tan, Chantal D, Hagedoorn, Nienke N, Dewez, Juan E, Borensztajn, Dorine M, von Both, Ulrich, Carrol, Enitan D ORCID: 0000-0001-8357-7726, Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro
et al (show 18 more authors) (2022) Rapid Viral Testing and Antibiotic Prescription in Febrile Children With Respiratory Symptoms Visiting Emergency Departments in Europe. PEDIATRIC INFECTIOUS DISEASE JOURNAL, 41 (1). pp. 39-44.

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Abstract

<h4>Background</h4>Inappropriate antibiotic prescribing often occurs in children with self-limiting respiratory tract infections, contributing to antimicrobial resistance. It has been suggested that rapid viral testing can reduce inappropriate antibiotic prescribing. We aimed to assess the association between rapid viral testing at the Emergency Department (ED) and antibiotic prescription in febrile children.<h4>Methods</h4>This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0-18 years) attending 12 European EDs. In children with respiratory symptoms visiting 6 EDs equipped with rapid viral testing, we performed multivariable logistic regression analysis regarding rapid viral testing and antibiotic prescription adjusted for patient characteristics, disease severity, diagnostic tests, focus of infection, admission, and ED.<h4>Results</h4>A rapid viral test was performed in 1061 children (8%) and not performed in 11,463 children. Rapid viral test usage was not associated with antibiotic prescription (aOR 0.9, 95% CI: 0.8-1.1). A positive rapid viral test was associated with less antibiotic prescription compared with children without test performed (aOR 0.6, 95% CI: 0.5-0.8), which remained significant after adjustment for CRP and chest radiograph result. Twenty percent of the positively tested children received antibiotics. A negative rapid viral test was not associated with antibiotic prescription (aOR 1.2, 95% CI: 1.0-1.4).<h4>Conclusions</h4>Rapid viral test usage did not reduce overall antibiotic prescription, whereas a positive rapid viral test did reduce antibiotic prescription at the ED. Implementation of rapid viral testing in routine emergency care and compliance to the rapid viral test outcome will reduce inappropriate antibiotic prescribing at the ED.

Item Type: Article
Uncontrolled Keywords: children, rapid viral test, antibiotics, emergency care
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 10 Feb 2022 10:07
Last Modified: 18 Jan 2023 21:12
DOI: 10.1097/INF.0000000000003326
Open Access URL: https://journals.lww.com/pidj/Fulltext/2022/01000/...
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3148603