Effect of rapid influenza testing on the clinical management of paediatric influenza.
BACKGROUND
Rapid tests are now widely available to assist the diagnosis of influenza; implementation may optimise the use of antiviral and antibiotic agents in the clinical management of influenza.


OBJECTIVE
To explore the clinical management of children with influenza-like illness (ILI) when rapid influenza tests were and were not performed.


METHODS
Between 15 January 2007 and 30 April 2007, a standardised questionnaire was used to record the clinical features of children aged 1-12 years who presented to office-based paediatricians in Germany with febrile ILI during periods of local influenza activity. For each paediatric contact, a clinical diagnosis of either 'influenza positive', 'influenza negative' or 'suspected ILI' was made. Where performed, the outcome of a Clearview Exact Influenza A + B rapid test was recorded. Prescriptions for antiviral agents and antibiotic medications were also recorded.


RESULTS
A total of 16 907 questionnaires were evaluated. After fever (an entry criteria for all children), cough (84.6%), fatigue/decreased activity (83.0%), rhinorrhoea (73.7%) and headache (67.1%) were the most common symptoms. Influenza was clinically diagnosed in 56.8% (9596/16 907) of cases. The antiviral oseltamivir was prescribed for 24.6% (178/725) of children who were influenza positive by symptom assessment alone and 60.1% (4618/7685) of children who were influenza positive by rapid test. Antibiotics were less commonly prescribed for children who were influenza positive by rapid test [3.5% (271/7685) versus 17.2% (125/725) for symptom assessment alone].


CONCLUSIONS
In children with ILI, a positive rapid test result for influenza promotes the rational use of antiviral agents and reduces the inappropriate use of antibiotic medications.
Jennings
Lance C
LC
Canterbury Health Laboratories, Christchurch, New Zealand. lance.jennings@cdhb.govt.nz
Skopnik
Heino
H
Burckhardt
Isabel
I
Hribar
Irene
I
Del Piero
Luc
L
Deichmann
Klaus A
KA
D000998:Antiviral Agents / Q000627:therapeutic use; D019090:Case Management; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods*; D005260:Female; D005858:Germany; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D025202:Molecular Diagnostic Techniques / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
D000998:Antiviral Agents