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PCR use among children with acute respiratory infections may reduce resource utilization

SAN DIEGO —Among children hospitalized for acute respiratory infections, using real-time PCR testing increased the number of isolation days but reduced antibiotic treatment and the use of chest X-rays, according to data presented here.

To assess the impact of real-time PCR testing on isolation days and resource utilization, Anupama Subramony, MD, of Columbia University Medical Center, and colleagues reviewed data for children aged 0 to 18 years hospitalized with acute respiratory infections who underwent respiratory diagnostic testing.

Researchers compared isolation days, prescribed antibiotic doses and utilization of chest X-rays prior to (June 2010 to May 2012) and following (June 2012 to May 2014) implementation of real-time PCR testing. The study included 1,831 patients in the pre-implementation study period and 1,926 patients in the post-implementation study period.

Anupama Subramony

Study participants in the pre-implementation period were younger than those in the post-implementation period (3.5 years vs. 4.3 years; P < .01).

Mean length of stay was similar among the two groups (8.4 days vs. 9.2 days; P = .08).

Children in the post-implementation period had a higher mean of isolation days per 100 patient days vs. children in the pre-implementation period (45.4 days vs. 24.4 days; P <.01).

Antibiotic doses per 100 patient days decreased between the pre- and post-implementation periods, from 144.6 doses to 120 doses (P < .01).

Further, chest X-ray was used less frequently during the post-implementation period compared with the pre-implementation period, (58.6% vs. 77.5%; P < .01).

“Overall antibiotic and chest X-ray utilization were lower in the multiplex PCR testing group; however, multiplex PCR testing was not independently associated with decreases in antibiotic or chest X-ray utilization but was associated with an increased use of isolation,” Subramony said during a presentation. “Future studies should focus on assessing the utility of using the testing for long periods of time to account for potential lag time after test introduction, to assess the impact of this increased use of isolation precautions on healthcare-associated infections and, finally, to define discrete populations for which multiplex PCR testing can be most cost-effective.” – by Amanda Oldt

Reference:

Subramony A, et al. Abstract #1180.5. Presented at: Pediatric Academic Societies 2015; April 25-28, 2015; San Diego.

Disclosure: Subramony reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.