Usefulness of rapid molecular tests in pediatric respiratory tract infections.

OBJECTIVE

To evaluate the role and the advantages of nasopharyngeal swabs in the detection of Influenza A and B viruses and Respiratory syncytial virus through a rapid test based upon a nucleic acid amplification reaction in order to avoid improper antibiotics use.

DESIGN

Case-control retrospective study.

SETTING

Emergency Room of "Sandro Pertini" General Hospital, Rome, Italy.

PARTICIPANTS

Children (< 14 years old) who consecutively arrived in the Emergency Department (ED) for respiratory tract infections, without obvious signs of bacterial respiratory tract infections and other comorbidities, in the maximal seasonal incidence period of November-to-March of every year between 2016 and 2020.

METHODS

Medical records of children included in the study were retrospectively examined. Children were subdivided according to the following intervals: 2016-2017 and 2017-2018 (Group 1), 2018-2019 and 2019-2020 (Group 2). Children in Group 2 undertook a nasopharyngeal swab, while those in Group 1 did not undergo any specific diagnostic test.

PRIMARY OUTCOME

Avoidance of improper antibiotics administration.

RESULTS

A total of 386 children were included in the study: 174 in Group 1, 212 in Group 2. The Odd Ratio (OR) of prescribing an antibiotic in the groups of children not being swabbed compared to those of children undertaking a swab was 9.21 (CI95% 5.6-15.2, p < 0.001). The overall percentage of hospitalizations, both in the short observation unit or in the pediatric unit, did not differ between the two groups.

CONCLUSIONS

Nasopharyngeal swabs for the detection of Influenza A and B viruses and Respiratory syncytial virus proved to be a useful means to a correct and timely diagnosis and allowed for a significant reduction in the prescription of antibiotic therapy.

TRIAL REGISTRATION

Retrospectively registered.