Rapid influenza diagnostic tests increased antiviral use

Rapid influenza diagnostic tests both decreased antibiotic prescriptions and increased antiviral use, according to study results published in the Journal of the Pediatric Infectious Diseases Society.

“When results of influenza tests are available to physicians at the ‘point of care,’ they use this information to provide more appropriate patient management,” Anne J. Blaschke, MD, PhD, of the University of Utah School of Medicine, said in a press release. “While other studies have shown that physicians can accurately diagnose influenza without testing, our results suggest that using an influenza test increases diagnostic certainty and leads to the physician providing more specific and appropriate care.”

Blaschke and colleagues used data from the National Hospital Ambulatory Medical Care survey to identify children and adults through three influenza seasons (2007 to 2009) diagnosed in the ED. How patients were diagnosed and the subsequent care they received were the primary outcomes.

Overall, 42% of influenza diagnoses were made in association with rapid influenza diagnostic testing (RIDT). Researchers also found that additional laboratory tests were ordered less frequently when a patient was diagnosed with rapid testing.

Twenty-three percent of patients diagnosed without rapid testing were given a prescription for antibiotics, which are not effective in treating influenza. However, only 11% of patients who were diagnosed with rapid testing received antibiotic prescriptions. Fifty-six percent of patients diagnosed with influenza by rapid testing received antivirals compared with 19% who did not receive rapid testing.

"While physicians can accurately diagnose influenza without testing, our results suggest that using an influenza test increasesdiagnostic certainty and leads to the physician providing more specific and appropriate care," Blaschke told Infectious Diseases in Children. "These data support the routine use of viral testing (including influenza and other respiratory viruses) for patients presenting to the emergency department with respiratory illness and suggest a role for physicians in advocating for faster and more accurate testing for infectious pathogens available at the bedside."

Anne J. Blaschke, MD, PhD, can be reached at the Department of Pediatrics, Division of Pediatric Infectious Diseases, 295 Chipeta Way, Salt Lake City, UT 84108; email: anne.blaschke@hsc.utah.edu.

Disclosure: See the study for a full list of researchers’ financial disclosures.