Antibiotic use in children is not influenced by the result of rapid antigen detection test for the respiratory syncytial virus.
BACKGROUND
Rapid antigen detection test (RADT) for respiratory syncytial virus (RSV) is widely used in children hospitalized with acute respiratory tract infection (ARTI), but its influence on antibiotic (AB) use is uncertain.


OBJECTIVE
To evaluate if confirmation of RSV infection by RADT modified AB use and elucidate others factors associated with the continuation of antibiotics.


METHODS
Charts of children hospitalized with viral ARTI aged 0-35 months were reviewed. Modification of antibiotics according to RSV RADT results was compared using Kaplan-Meier estimates and multivariate Cox regression.


RESULTS
Of children receiving antibiotics when the RSV RADT result was available, RSV RADT was positive in 144 and negative in 54. Positive RSV RADT results did not lead to modification of antibiotic use. Factors independently associated with cessation of intravenous antibiotics were age > or = 3 months (HR 2.44 [1.41-4.21]) and absence of pneumonia (HR 1.50 [1.03-2.19]). Absence of otitis was associated with cessation of oral antibiotics (HR 9.16 [95% CI, 2.35-35.76]).


CONCLUSIONS
Confirmed presence of RSV by RADT did not influence antibiotic use in young children with ARTI. Except with pneumonia, the risk of bacterial superinfection of RSV infected children is minimal and confirmation of RSV infection should prompt treating physicians to interrupt antibiotics.
Thibeault
Roseline
R
Université Laval, Québec G1K 7P4, Canada.
Gilca
Rodica
R
Côté
Stéphanie
S
De Serres
Gaston
G
Boivin
Guy
G
Déry
Pierre
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000956:Antigens, Viral / Q000032:analysis*; D001424:Bacterial Infections / Q000188:drug therapy / Q000517:prevention & control; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000276:immunology / Q000302:isolation & purification*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000956:Antigens, Viral