Effect of rapid diagnosis on management of influenza A infections

Background. Few studies have examined the impact of rapid viral diagnostic tests on patient management. Objective. To assess the effect of rapid diagnosis of influenza A infection s on patient management. Methods. The medical records of children with respiratory infections who we re evaluated at a children's hospital between July 1, 1995, and June 30, 19 97, were reviewed. Children (n = 56) evaluated in the Emergency Department (ED) who had a positive influenza A enzyme immunoassay (EIA) were compared with two control groups for the likelihood of admission, antibiotic use and duration of hospitalization and antibiotic administration. Results. Patients discharged from the ED with a positive EIA test were less likely to receive antibiotics than those with a negative EIA test (20% vs. 53%; P = 0.04). Patients admitted to the hospital with a positive EIA test were as likely to receive antibiotics as those without a rapid diagnosis, but the duration of antibiotic administration was significantly shorter in the group with a positive EIA test (3.5 vs. 5.4 days; P = 0.03). Patients w ith a positive ELA test also were more likely to receive antiviral therapy than either control group (25% vs. 0 and 1.8%; P < 0.001). Conclusions. The detection of influenza A by EIA has a positive impact on m edical management by decreasing antibiotic use in pediatric patients evalua ted in an ED, by decreasing the duration of antibiotic use in hospitalized patients and by encouraging antiviral therapy.