title: Impact of Multiplex Polymerase Chain Reaction Testing for Respiratory Pathogens on Healthcare Resource Utilization for Pediatric Inpatients.
abstract: To assess whether multiplex polymerase chain reaction (mPCR) vs non-mPCR testing impacts the use of antibiotics, chest radiographs, and isolation precautions.
  
  
  
  We retrospectively compared use of antibiotics, chest radiographs, and isolation precautions for patients <18 years old (excluding neonates) hospitalized at a tertiary referral center tested for respiratory pathogens in the emergency department or during the first 2 hospital days, during 2 periods: June 2010-June 2012 (non-mPCR group) vs October 2012-May 2014 (mPCR group).
  
  
  
  Subjects (n = 2430) in the mPCR group were older, had more complex chronic conditions, and were admitted to the pediatric intensive care unit more often compared with the non-mPCR (n = 2349) group. Subjects in the mPCR group had more positive tests (42.4% vs 14.4%, P < .01), received fewer days of antibiotics (4 vs 5 median antibiotic days, P < .01), fewer chest radiographs performed, (59% vs 78%, P < .01), and were placed in isolation longer (20 vs 0 median isolation-hours, P < .01) compared with the non-mPCR group. In multivariable regression, patients tested with mPCR were less likely to receive antibiotics for ≥2 days (OR 0.5, 95% CI 0.5-0.6), chest radiographs at admission (OR 0.4, 95% CI 0.3-0.4), and more likely to be in isolation for ≥2 days (OR 2.4, 95% CI 2.1-2.8) compared with the non-mPCR group.
  
  
  
  Use of mPCR testing for respiratory viruses among hospitalized patients was significantly associated with decreased healthcare resource utilization, including decreased use of antibiotics and chest radiographs, and increased use of isolation precautions.
authors.affiliation: Department of Pediatrics, Cohen Children's Medical Center, Hofstra-Northwell School of Medicine, New Hyde Park, NY. Electronic address: anusubramony@gmail.com.
authors.forename: Anupama
authors.initials: A
authors.lastname: Subramony
authors.affiliation: Department of Pediatrics, Columbia University Medical Center, New York, NY; NewYork-Presbyterian Hospital, New York, NY.
authors.forename: Philip
authors.initials: P
authors.lastname: Zachariah
authors.affiliation: Department of Medicine, Virginia Commonwealth University Medical Center, Richmond, VA.
authors.forename: Ariella
authors.initials: A
authors.lastname: Krones
authors.affiliation: Department of Pediatrics, Columbia University Medical Center, New York, NY; NewYork-Presbyterian Hospital, New York, NY.
authors.forename: Susan
authors.initials: S
authors.lastname: Whittier
authors.affiliation: Department of Pediatrics, Columbia University Medical Center, New York, NY; NewYork-Presbyterian Hospital, New York, NY.
authors.forename: Lisa
authors.initials: L
authors.lastname: Saiman
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D060885:Multiplex Polymerase Chain Reaction; D009519:New York City / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010356:Patient Isolation / Q000706:statistics & numerical data; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Health resources; Respiratory pathogen testing; Respiratory viral panel