title: Impact of rapid influenza PCR testing on hospitalization and antiviral use: A retrospective cohort study.
abstract: Rapid PCR-based influenza tests are increasingly used as point-of-care diagnostics in hospitals and clinics. To our knowledge, no prior studies have described clinical outcomes with implementation of rapid PCR-based influenza tests in hospitalized adult inpatients. Electronic medical records were used to assess differences in laboratory testing time and antiviral use among a subset of 175 consecutive adult inpatients tested for influenza in two respiratory seasons before and after implementation of rapid PCR-based influenza testing at an academic medical center. Of the 350 hospitalized inpatients included in this analysis, 96 (27%) were over 65 years of age and 308 (88%) had a comorbid condition. The overall time to result decreased significantly from 25.2 to 1.7 hr (P < 0.001) after implementation of rapid PCR-based influenza testing. Among influenza-negative patients, the frequency of oseltamivir initiation remained unchanged (before: 43% vs. after: 45%; P = 0.60), though the median duration of oseltamivir was significantly decreased from 1.1 to 0.0 days (P < 0.001). By providing an earlier result to clinicians, rapid PCR-based influenza tests may decrease unnecessary antiviral use among adult inpatients who test negative for influenza.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: Helen Y
authors.initials: HY
authors.lastname: Chu
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Englund
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: Dandi
authors.initials: D
authors.lastname: Huang
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: Emily
authors.initials: E
authors.lastname: Scott
authors.affiliation: Department of Pharmacy, University of Washington, Seattle, Washington.
authors.forename: Jeanne D
authors.initials: JD
authors.lastname: Chan
authors.affiliation: Department of Pharmacy, University of Washington, Seattle, Washington.
authors.forename: Rupali
authors.initials: R
authors.lastname: Jain
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Pottinger
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: John B
authors.initials: JB
authors.lastname: Lynch
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Dellit
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, Washington.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Jerome
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, Washington.
authors.forename: Jane
authors.initials: J
authors.lastname: Kuypers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007251:Influenza, Human / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D053139:Oseltamivir / Q000627:therapeutic use; D016133:Polymerase Chain Reaction / Q000379:methods*; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir
keywords: PCR; infection control; influenza; oseltamivir