East Tennessee State University Bill Gatton College of Pharmacy, Johnson City, TN, USA.
Johnson City Medical Center, Johnson City, TN, USA.
J Clin Pharm Ther. 2021 Apr;46(2):277-285. doi: 10.1111/jcpt.13326. Epub 2020 Dec 5.
The development of rapid diagnostics has revolutionized antimicrobial stewardship with efforts targeting earlier de-escalation or discontinuation of antibiotics. The respiratory viral panel (RVP) is one tool quickly able to detect common viral and bacterial pathogens using polymerase chain reaction technology. Utility may be further enhanced in conjunction with procalcitonin (PCT). However, the optimal use of the RVP to the clinical pharmacist in the treatment of community-acquired respiratory infections remains unclear.
The purpose of this guide is to review the available literature regarding the impact of the RVP with and without procalcitonin on antimicrobial stewardship efforts and to provide guidance on how to use each of these tools.
In total, 13 studies were included, 5 of which utilized PCT in conjunction with RVP and 8 of which did not use PCT. The majority of studies were retrospective in nature, and the most common outcomes evaluated were antibiotic days of therapy (DOT) and time to antibiotic discontinuation.
After review, RVP alone has limited value to antimicrobial stewardship; however, when used in conjunction with procalcitonin, RVP has the potential to reduce antibiotic use and duration.
快速诊断技术的发展使抗菌药物管理发生了革命性变化，努力目标是更早地降低或停止使用抗生素。呼吸道病毒检测试剂盒（RVP）是一种能够利用聚合酶链反应技术快速检测常见病毒和细菌病原体的工具。与降钙素原（PCT）结合使用可能会进一步增强其效用。然而，RVP 在治疗社区获得性呼吸道感染方面对临床药师的最佳使用方法仍不清楚。
本指南的目的是回顾有关 RVP 与 PCT 联合应用或不联合应用对抗菌药物管理的影响的现有文献，并提供如何使用这些工具的指导。
共纳入 13 项研究，其中 5 项研究将 PCT 与 RVP 联合使用，8 项研究未使用 PCT。大多数研究具有回顾性，最常见的评估结果是抗生素治疗日（DOT）和抗生素停药时间。
经过审查，RVP 本身对抗菌药物管理的价值有限；然而，当与降钙素原联合使用时，RVP 有可能减少抗生素的使用和持续时间。
