A rapid aetiologic diagnosis using a multiplex RTPCR panel can reduce antibiotic prescription rate in respiratory tract infections a randomized prospective study

Abstract number: P1332

Brittain-Long R., Westin J., Olofsson S., Lindh M., Andersson L.M.

Objective: Etiologic diagnosis in acute respiratory infections (ARTI's) is difficult yet crucial for the decision to use antibiotics or not. Recently, multiplex real time PCR methods, that detect several common respiratory viruses, with high sensitivity allowing a rapid result, have been introduced. The objective of the study was to evaluate if the use of such a method in community-acquired ARTI would have an impact on the antibiotic prescription rate.

Methods and Study design: In an open randomized prospective study, nasopharyngeal and throat swabs were collected from adult patients, seeking primary health care with symptoms of respiratory tract infection during 3 consecutive winter seasons (Oct-Apr 2006–2009). Patients were randomized to receive either a quick result (the following day) or a delayed result (after 10 days ±2), which was given at a follow up consultation offered for all patients. Any treatment options were left at the discretion of the physician. The real-time multiplex PCR targeted the following 15 respiratory agents; parainfluensavirus 1–3 (PIV), influensavirus A (IfA) and B (IfB), human metapneumovirus (MPV), respiratory syncytial virus (RSV), rhinovirus (RV), enterovirus (EV), adenovirus (AdV), human coronaviruses 229E, OC43 and NL63, M. pneumoniae and C. pneumoniae.

Results: 426 patients were included in the study, of whom 206 (48%) were positive for one or more agents at initial visit. 13 patients (6.3%) had double infections. Influenza A virus was most commonly found (28%), followed by rhinovirus (22%) and coronaviruses (15%). Antibiotics were prescribed in 10.8% (n = 46) of the cases at initial visit. In the group randomized to a quick PCR result, 15 patients (7.2%) received antibiotic treatment, compared to 31 patients (14.2%) in the delayed result group (p < 0.02, c2 test).

Conclusion: The use of a multiplex real time PCR panel for etiologic diagnosis of viral ARTI's may be a useful tool in reducing overuse of antibiotics in an outpatient setting.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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