Role of a respiratory viral panel in the clinical management of pediatric inpatients

Grant S. Schulert, Zengqi Lu, Tammy Wingo, Yi Wei Tang, Benjamin R. Saville, Paul D. Hain

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Background: Respiratory viral panels (RVPs) able to detect multiple pathogens are increasingly used in the management of pediatric inpatients. Despite this, few studies have examined whether the results of these tests are associated with clinically significant changes in medical management. Methods: In this retrospective cohort study, we identified pediatric inpatients between August 2009 and December 2010 for whom an RVP was ordered within 24 hours of admission to a large, tertiary-care children's hospital. We used linear regression to determine whether RVP was associated with length of stay (LOS), duration of antibiotics and the number of diagnostic microbiology tests ordered, adjusting for potential confounders. Results: We found that the association between results of the RVP and LOS was dependent on a patient's admission service, specifically admission to the hematology/oncology service. We also found that patients with a positive RVP had a shorter duration of intravenous antibiotic administration (P = 0.03; 42% reduction in the geometric mean), but that this was influenced by the primary admission service. We also found that positive results of the RVP were associated with decreased LOS and shorter duration of antibiotics in patients with some common respiratory diagnoses. Conclusions: This study lacked sufficient evidence to claim an association between a positive RVP and LOS in pediatric patients, adjusting for their underlying diagnosis. However, we found that a positive RVP was associated with a shorter duration of intravenous antibiotic administration in certain groups of patients and those with some common respiratory diagnoses. These findings help clarify the utility of rapid viral testing in the management of hospitalized pediatric patients.

Original languageEnglish (US)
Pages (from-to)467-472
Number of pages6
JournalPediatric Infectious Disease Journal
Volume32
Issue number5
DOIs
StatePublished - May 2013

Keywords

  • Antibiotics
  • Length of stay
  • Pneumonia
  • Respiratory viral panel
  • Virus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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