ArticleInfectious diseases and therapy2015
Antibiotic Discontinuation Rates Associated with Positive Respiratory Viral Panel and Low Procalcitonin Results in Proven or Suspected Respiratory Infections.
Article in Infectious diseases and therapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Rapid Molecular Tests for Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses: A Systematic Review of Diagnostic Accuracy and Clinical Impact Studies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Pooled it
- Influenza and other respiratory viruses: standardizing disease severity in surveillance and clinical trials.Expert review of anti-infective therapy · 2017Pooled it
- Scenario-Driven Rapid Testing for Top Pathogens in Pediatric Respiratory Infections: Clinical and Economic Value from Emergency Triage to Precision Anti-Infective Management in the PICU.Pathogens (Basel, Switzerland) · 2026Review
- Measuring clinical outcomes of highly multiplex molecular diagnostics for respiratory infections: A systematic review and conceptual framework.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Leveraging diagnostic stewardship within antimicrobial stewardship programmes.Drugs in context · 2023Review
- Impact of multiplexed respiratory viral panels on infection control measures and antimicrobial stewardship: a review of the literature.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Review
- Clinical Outcome of Viral Respiratory Tract Infections in Hospitalized Adults in Norway: High Degree of Inflammation and Need of Emergency Care for Cases With Respiratory Syncytial Virus.Frontiers in medicine · 2022Article
- BioFireInfectious diseases and therapy · 2021Article
- Respiratory viral testing and antibacterial treatment in patients hospitalized with community-acquired pneumonia.Infection control and hospital epidemiology · 2021Article
- Use of Procalcitonin and a Respiratory Polymerase Chain Reaction Panel to Reduce Antibiotic Use via an Electronic Medical Record Alert.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Low Uptake of Rapid Diagnostic Tests for Respiratory Tract Infections in an Urban Safety Net Hospital.Open forum infectious diseases · 2020Article
- Challenges in Implementing Antimicrobial Stewardship Programmes at Secondary Level Hospitals in India: An Exploratory Study.Frontiers in public health · 2020Article
- Article
- Opportunities Revealed for Antimicrobial Stewardship and Clinical Practice with Implementation of a Rapid Respiratory Multiplex Assay.Journal of clinical microbiology · 2019Article
- More targeted use of oseltamivir and in-hospital isolation facilities after implementation of a multifaceted strategy including a rapid molecular diagnostic panel for respiratory viruses in immunocompromised adult patients.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2019Article
- Rapid respiratory panel testing: Impact of active antimicrobial stewardship.American journal of infection control · 2019Article
- Article
- Influenza and Viral Pneumonia.Clinics in chest medicine · 2018Review
- The rapid diagnosis of viral respiratory tract infections and its impact on antimicrobial stewardship programs.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2018Observational
- Stewardship opportunities in viral pneumonia: Why not the immunocompromised?Transplant infectious disease : an official journal of the Transplantation Society · 2018Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe differentiation of viral from bacterial pneumonia is important in determining whether antibiotics are appropriate for treatment of these infections. Advances in diagnostic technologies such as respiratory panels (RP) utilizing polymerase chain reactions to detect viruses and determination of procalcitonin (PCT) concentrations may aid in this differentiation. However, some studies have shown limited impact for this purpose and thus continuation of antibiotics despite results suggesting viral infection. Our objective was to characterize clinician-prescribing behavior at our institution once RP and/or PCT results were known and suggestive of a viral respiratory infection.
methodsThis retrospective analysis was based upon records of hospitalized patients in whom proven or possible respiratory infections as indicated by RP testing, respiratory bacterial culture or International Statistical Classification of Diseases and Related Health Problems 9th revision codes for acute infectious respiratory illness was documented. Patients evaluated were required to have a RP or PCT within the first 72 h of presentation. Drug orders were evaluated for discontinuation of antibiotic therapy within 48 h of a procalcitonin of <0.25 μg/mL, a positive viral RP result, or both.
resultsOf 4869 patients with PCT and/or RP results, 2031 were included. PCT and RP testing were obtained in 503 and 1823 patients, respectively, with 295 patients having both. Results of these tests suggested 789 patients were potential candidates for antibiotic avoidance. These included 219 with a PCT <0.25 μg/mL, 601 with a positive viral RP result, and 31 with both. Antibiotics were administered to 307 patients (39%) within the first 72 h. In these, antibiotics were discontinued within 48 h of laboratory results availability.
conclusionThese results suggest that positive viral RP and low PCT results are infrequently associated with discontinuation of antibiotic therapy in proven or possible respiratory infections at our institution. Direct interventions with clinicians are likely needed to correct this behavior and decrease unnecessary antibiotic use.
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