Manatrey-Lancaster Jenna J, Bushman Amanda M, Caligiuri Meagan E, Rosa Rossana
Department of Pharmacy, UnityPoint Health-Des Moines, Des Moines, Iowa.
Infectious Diseases Service, UnityPoint Health-Des Moines, Des Moines, Iowa.
Antimicrob Steward Healthc Epidemiol. 2021 Jun 24;1(1):e4. doi: 10.1017/ash.2021.164. eCollection 2021.
The BioFire FilmArray Respiratory Panel (RFA) has been proposed as a tool that can aid in the timely diagnosis and treatment of respiratory tract infections but its effect on antibiotic prescribing among adult patients has varied. We evaluated the impact of RFA result on antibiotic days of therapy (DOTs) in 2 distinct cohorts: hospitalized patients and patients discharged from the emergency department (ED).
Retrospective cohort study.
The study was conducted in 3 community hospitals in Des Moines, Iowa, from March 3 to March 16, 2019.
Adults aged >18 years.
Potential outcome means and average treatment effects for RFA results on antibiotic DOTs were estimated. Inverse probability of treatment weighting with regression adjustment was used.
We identified 243 patients each in the hospitalized and ED-discharged cohorts. Among hospitalized patients, RFA results did not affect antibiotic DOTs. Among patients discharged from the ED, we found that if all patients had had influenza detected, the average DOTs would have been 2.3 DOTs (-3.2 to -1.4) less than the average observed if all the patients had had a negative RFA ( < .0001); no differences in DOTs were observed when comparing an RFA with a noninfluenza virus detected compared to an RFA with negative results.
The impact of RFA results on antibiotic DOTs varies by clinical setting, and reductions were observed only among patients discharged from the ED who had influenza A or B detected.
BioFire FilmArray呼吸道检测板(RFA)已被提议作为一种有助于及时诊断和治疗呼吸道感染的工具,但其对成年患者抗生素处方的影响各不相同。我们在两个不同队列中评估了RFA结果对抗生素治疗天数(DOTs)的影响:住院患者和从急诊科(ED)出院的患者。
回顾性队列研究。
该研究于2019年3月3日至3月16日在爱荷华州得梅因的3家社区医院进行。
年龄>18岁的成年人。
估计RFA结果对抗生素DOTs的潜在结果均值和平均治疗效果。使用回归调整的治疗加权逆概率法。
我们在住院队列和ED出院队列中各确定了243名患者。在住院患者中,RFA结果不影响抗生素DOTs。在从ED出院的患者中,我们发现,如果所有患者都检测出流感,平均DOTs将比所有患者RFA结果为阴性时观察到的平均DOTs少2.3天(-3.2至-1.4天)(P<.0001);将检测到非流感病毒的RFA与结果为阴性的RFA进行比较时,DOTs没有差异。
RFA结果对抗生素DOTs的影响因临床环境而异,仅在从ED出院且检测出甲型或乙型流感的患者中观察到DOTs减少。