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Clinical Utility of On-Demand Multiplex Respiratory Pathogen Testing among Adult Outpatients

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  • Clinical Utility of On-Demand Multiplex Respiratory Pathogen Testing among Adult Outpatients

    J Clin Microbiol. 2016 Sep 21. pii: JCM.01579-16. [Epub ahead of print]
    Clinical Utility of On-Demand Multiplex Respiratory Pathogen Testing among Adult Outpatients.

    Green DA1, Hitoaliaj L2, Kotansky B2, Campbell SM1, Peaper DR3.
    Author information

    Abstract

    Multiplex tests for respiratory tract infections include up to 20 targets for common pathogens, predominantly viruses. A specific therapeutic intervention is available for those testing positive for influenza viruses (oseltamivir), and it is potentially beneficial to identify non-influenza viruses to avoid unnecessary antibiotic use. We evaluated antimicrobial prescriptions following respiratory pathogen testing among outpatients at a large Veterans Administration (VA) medical center. Results of the FilmArray Respiratory Panel (Biofire, Salt Lake City, UT) from December 15, 2014 to April 15, 2015 were evaluated among 408 outpatients, and patient medical records were reviewed. Differences in antibiotic and oseltamivir prescription rates were analyzed. Among 408 patients tested in outpatient centers (emergency department, urgent care, and outpatient clinics), 295 (72.3%) were managed as outpatients. Among these 295 outpatients, 105 (35.6%) tested positive for influenza, 109 (36.9%) tested positive for a non-influenza pathogen, and 81 (27.5%) had no respiratory pathogen detected. Rates of oseltamivir and antibiotic prescriptions were significantly different among the three test groups (Chi-squared = 167.6, p < 0.0001 and Chi-squared = 10.48, p = 0.005, respectively), but there was no significant difference in antibiotic prescription rates between the non-influenza pathogen group and those who tested negative (Chi-square = 0; p = 1.0). Among adult outpatients, testing positive for influenza was associated with receiving fewer antibiotic prescriptions, but no such effect was seen for those who tested positive for a non-influenza virus. These data suggest that testing for influenza viruses alone may be sufficient and more cost-effective than multiplex pathogen testing for outpatients.
    Copyright ? 2016, American Society for Microbiology. All Rights Reserved.


    PMID: 27654334 DOI: 10.1128/JCM.01579-16
    [PubMed - as supplied by publisher]
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