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Rapid Molecular Detection and Differentiation of Influenza Viruses A and B
Published on: January 30, 2017
Effect of rapid influenza testing on the clinical management of paediatric influenza
Lance C Jennings1, Heino Skopnik, Isabel Burckhardt
1Canterbury Health Laboratories, Christchurch, New Zealand. lance.jennings@cdhb.govt.nz
Insights
Rapid influenza diagnostic tests improve the clinical management of children with influenza-like illness. Positive rapid test results promote appropriate antiviral use and reduce unnecessary antibiotic prescriptions.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Diagnostics
- Antimicrobial Stewardship
Background:
- Rapid influenza diagnostic tests are increasingly available for clinical use.
- Optimizing the use of antiviral and antibiotic agents is crucial in managing influenza.
Purpose of the Study:
- To investigate the clinical management of children presenting with influenza-like illness (ILI).
- To compare management strategies with and without the performance of rapid influenza diagnostic tests.
Main Methods:
- A standardized questionnaire collected data from children aged 1-12 years with febrile ILI in Germany.
- Clinical diagnosis, rapid influenza test results, and prescriptions for antivirals and antibiotics were recorded.
- Data from 16,907 patient encounters were analyzed.
Main Results:
- Common symptoms included fever, cough, fatigue, rhinorrhoea, and headache.
- Rapid influenza testing led to a significant increase in oseltamivir prescription for confirmed influenza cases (60.1% vs. 24.6%).
- Antibiotic prescriptions were substantially lower in children with positive rapid tests (3.5% vs. 17.2%).
Conclusions:
- Positive rapid influenza test results guide appropriate antiviral prescribing in children with ILI.
- Rapid testing effectively reduces the inappropriate use of antibiotic medications in pediatric influenza cases.
Background:
Rapid tests are now widely available to assist the diagnosis of influenza; implementation may optimise the use of antiviral and antibiotic agents in the clinical management of influenza.
Objective:
To explore the clinical management of children with influenza-like illness (ILI) when rapid influenza tests were and were not performed.
Methods:
Between 15 January 2007 and 30 April 2007, a standardised questionnaire was used to record the clinical features of children aged 1-12 years who presented to office-based paediatricians in Germany with febrile ILI during periods of local influenza activity. For each paediatric contact, a clinical diagnosis of either 'influenza positive', 'influenza negative' or 'suspected ILI' was made. Where performed, the outcome of a Clearview Exact Influenza A + B rapid test was recorded. Prescriptions for antiviral agents and antibiotic medications were also recorded.
Results:
A total of 16 907 questionnaires were evaluated. After fever (an entry criteria for all children), cough (84.6%), fatigue/decreased activity (83.0%), rhinorrhoea (73.7%) and headache (67.1%) were the most common symptoms. Influenza was clinically diagnosed in 56.8% (9596/16 907) of cases. The antiviral oseltamivir was prescribed for 24.6% (178/725) of children who were influenza positive by symptom assessment alone and 60.1% (4618/7685) of children who were influenza positive by rapid test. Antibiotics were less commonly prescribed for children who were influenza positive by rapid test [3.5% (271/7685) versus 17.2% (125/725) for symptom assessment alone].
Conclusions:
In children with ILI, a positive rapid test result for influenza promotes the rational use of antiviral agents and reduces the inappropriate use of antibiotic medications.
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