A comparison of 2 white blood cell count devices to aid judicious antibiotic prescribing.
A low or normal white blood cell (WBC) count is usually associated with viral illnesses. This study evaluated the reliability of a new point-of-care, inexpensive, WBC count device which requires only 10 microL (1 drop) of whole blood from a finger stick to an automated Cell-Dyn counter in a busy office practice setting and assessed its reliability to assist in avoiding antibiotic prescribing. A total of 120 acutely ill children and potential antibiotic recipients were studied from October 2007 to March 2008. The mean WBC count was 7.4x10(9)/L and 8.1x10( 9)/L for the new WBC device and the automated Cell-Dyn counter, respectively. The correlation between the 2 devices was high (r=.988, P=.005). A total of 88 children (73%) did not receive antibiotics and mean WBC was 7.2x10(9)/L. In all, 32 children (27%) received an antibiotic and 1 (3%) returned for a follow-up office visit for the same or a related illness. Of the 88 children with a low blood count who did not receive an antibiotic, 3 (3%) had return visit within 30 days and received an antibiotic. A simple and quick point-of-care WBC count device produces similar results as achievable with a Cell-Dyn counter for total WBCs and may assist in judicious antibiotic prescribing.
Casey
Janet R
JR
Legacy Pediatrics, Department of Pediatrics, University of Rochester, Rochester, New York, 14642, USA.
Pichichero
Michael E
ME
D000293:Adolescent; D000553:Ambulatory Care / Q000379:methods*; D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count / Q000295:instrumentation / Q000379:methods; D008297:Male; D010372:Pediatrics / Q000295:instrumentation* / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult
D000900:Anti-Bacterial Agents