title: The current epidemiology and clinical decisions surrounding acute respiratory infections.
abstract: Acute respiratory infection (ARI) is a common diagnosis in outpatient and emergent care settings. Currently available diagnostics are limited, creating uncertainty in the use of antibacterial, antiviral, or supportive care. Up to 72% of ambulatory care patients with ARI are treated with an antibacterial, despite only a small fraction actually needing one. Antibiotic overuse is not restricted to ambulatory care: ARI accounts for approximately 5 million emergency department (ED) visits annually in the USA, where 52-61% of such patients receive antibiotics. Thus, an accurate test for the presence or absence of viral or bacterial infection is needed. In this review, we focus on recent research showing that the host-response (genomic, proteomic, or miRNA) can accomplish this task.
authors.affiliation: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: aimee.zaas@duke.edu.
authors.forename: Aimee K
authors.initials: AK
authors.lastname: Zaas
authors.affiliation: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Bronwen H
authors.initials: BH
authors.lastname: Garner
authors.affiliation: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Durham Veterans Affairs Medical Center, Durham, NC, USA.
authors.forename: Ephraim L
authors.initials: EL
authors.lastname: Tsalik
authors.affiliation: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Burke
authors.affiliation: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Durham Veterans Affairs Medical Center, Durham, NC, USA.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Woods
authors.affiliation: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Ginsburg
mesh_terms: D015415:Biomarkers / Q000032:analysis; D015870:Gene Expression; D020869:Gene Expression Profiling / Q000379:methods; D054884:Host-Pathogen Interactions / Q000235:genetics; D006801:Humans; D055432:Metabolomics / Q000379:methods; D035683:MicroRNAs; D025202:Molecular Diagnostic Techniques; D040901:Proteomics / Q000379:methods; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics / Q000382:microbiology / Q000821:virology
chemical_list: D015415:Biomarkers; D035683:MicroRNAs
keywords: genomics; host–pathogen interaction; viral respiratory infection