title: Role of a respiratory viral panel in the clinical management of pediatric inpatients.
abstract: BACKGROUND
  Respiratory viral panels (RVPs) able to detect multiple pathogens are increasingly used in the management of pediatric inpatients. Despite this, few studies have examined whether the results of these tests are associated with clinically significant changes in medical management.
  
  
  METHODS
  In this retrospective cohort study, we identified pediatric inpatients between August 2009 and December 2010 for whom an RVP was ordered within 24 hours of admission to a large, tertiary-care children's hospital. We used linear regression to determine whether RVP was associated with length of stay (LOS), duration of antibiotics and the number of diagnostic microbiology tests ordered, adjusting for potential confounders.
  
  
  RESULTS
  We found that the association between results of the RVP and LOS was dependent on a patient's admission service, specifically admission to the hematology/oncology service. We also found that patients with a positive RVP had a shorter duration of intravenous antibiotic administration (P = 0.03; 42% reduction in the geometric mean), but that this was influenced by the primary admission service. We also found that positive results of the RVP were associated with decreased LOS and shorter duration of antibiotics in patients with some common respiratory diagnoses.
  
  
  CONCLUSIONS
  This study lacked sufficient evidence to claim an association between a positive RVP and LOS in pediatric patients, adjusting for their underlying diagnosis. However, we found that a positive RVP was associated with a shorter duration of intravenous antibiotic administration in certain groups of patients and those with some common respiratory diagnoses. These findings help clarify the utility of rapid viral testing in the management of hospitalized pediatric patients.
authors.affiliation: Department of Pediatrics, Vanderbilt University, Nashville, TN, USA. grant.s.schulert@vanderbilt.edu
authors.forename: Grant S
authors.initials: GS
authors.lastname: Schulert
authors.forename: Zengqi
authors.initials: Z
authors.lastname: Lu
authors.forename: Tammy
authors.initials: T
authors.lastname: Wingo
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Tang
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Saville
authors.forename: Paul D
authors.initials: PD
authors.lastname: Hain
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D016014:Linear Models; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology*; D012189:Retrospective Studies; D014773:Virology / Q000379:methods*; D014780:Viruses / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents