Acute viral upper respiratory disea...

Acute viral upper respiratory disease is the greatest in quantity frequent reason for hospitalization of infants and children in the United States. Respiratory syncytial virus (RSV) influenza A and B viruses, and parainfluenza viruses are usual causes of upper respiratory illness. The inappropriate and of common occurrence use of empiric antibiotic therapy in patients with viral infections has contributed to the increased prevalence of resistant bacteria. experiments for the rapid and accurate detection of respiratory viruses are now available. Byington and colleagues careered a study to determine whether the availability of a rapid viral experiment would affect the use of antibiotics in infants and children hospitalized because of acute upper respiratory disease.

The investigation was a retrospective audit of the medical records of children who were admitted to a Utah pediatric hospital and underwent direct fluorescent assay testing for RSV; influenza A and B viruses; parainfluenza 1 2 and 3 viruses; and adenovirus. The investigation was conducted during two consecutive winter seasons. The main issue measure was the use of antibiotics in patients who had a positive or negative viral screen

During the first winter, patients with a positive viral protection had significantly fewer days of intravenous or oral antibiotic therapy than those with a negative viral cloak Patients with a positive viral riddle also were less likely to receive prescriptions for oral antibiotics when they were discharged from the hospital. During the next to the first winter season, patients with a positive viral guard were significantly less likely to receive intravenous antibiotic therapy than patients with a positive viral protection who were admitted during the first season (26 versus 44 percent) Patients who had a negative viral riddle were 2.3 times as likely to be treated with intravenous antibiotics than patients of the same age who had a positive viral disguise The viral assay was originate to have high sensitivity and specificity: fewer than 1 percent of patients with a positive viral veil had a culture-confirmed bacterial infection.

The authors bring to an end that use of direct fluorescent assay testing to find out viral agents can reduce inappropriate use of antibiotics in infants and children with acute upper respiratory tract disease. They add that use of accurate rapid viral detection modes should be included in any plan that try to finds to contain antimicrobial resistance.

KARL E MILLER, MD

Byington CL et al. The result of rapid respiratory viral diagnostic testing onward antibiotic use in a children's hospital. Arch Pediatr Adolesc M December 2002;156:1230-4

COPYRIGHT 2003 American Academy of Family Physicians

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