One of the most common causes of pediatric emergency department and urgent care visits is acute respiratory infections. Around 55-57% children presenting in these settings are prescribed antibiotics, despite these infections having primarily viral causes. The overuse of antibiotics can have negative consequences such as antibiotic resistance, increased healthcare costs, and adverse drug events. Respiratory pathogen identification could lead to improved evaluation and management of acute respiratory infection in children; it could also lead to decreases in the overuse of antibiotics. New advances in rapid respiratory virus testing provide an opportunity for the identification of pathogens in short timeframes in the emergency department and urgent care setting. A new randomized trial examined whether rapid knowledge of the pathogen impacted the prescribing patterns of physicians in these settings.
Public Health Impact
The study looked at children aged 1 month to 18 years who came to the emergency department with influenza-like illness. The children were all given a nasopharyngeal swab for rapid testing and were randomized into two groups: the control group whose clinicians did not receive the results of the rapid test and the intervention group whose clinicians did receive the results of the rapid test. Researchers found that there was no significant difference in the prescribing patterns of physicians treating children with influenza-like illness, whether or not they received the results of a rapid respiratory virus test. Antibiotic prescribing did not decrease in this trial, demonstrating that there may be a limited role for testing children for respiratory pathogens in this setting.
