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Rapid Viral Testing and Antibiotic Prescription in Febrile Children with Respiratory Symptoms Visiting Emergency Departments in Europe

Lookup NU author(s): Professor Marieke Emonts-le ClercqORCiD, Dr Emma Lim



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Lippincott Williams and Wilkins, 2022.

For re-use rights please refer to the publisher's terms and conditions.


Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.Background. Inappropriate antibiotic prescribing often occurs in children with self-limiting respiratory tract infections, contributing to antimicrobial resistance. It has been suggested that rapid viral testing can reduce inappropriate antibiotic prescribing. We aimed to assess the association between rapid viral testing at the Emergency Department (ED) and antibiotic prescription in febrile children. Methods. This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0-18 years) attending 12 European EDs. In children with respiratory symptoms visiting 6 EDs equipped with rapid viral testing, we performed multivariable logistic regression analysis regarding rapid viral testing and antibiotic prescription adjusted for patient characteristics, disease severity, diagnostic tests, focus of infection, admission, and ED. Results. A rapid viral test was performed in 1061 children (8%) and not performed in 11,463 children. Rapid viral test usage was not associated with antibiotic prescription (aOR 0.9, 95% CI: 0.8-1.1). A positive rapid viral test was associated with less antibiotic prescription compared with children without test performed (aOR 0.6, 95% CI: 0.5-0.8), which remained significant after adjustment for CRP and chest radiograph result. Twenty percent of the positively tested children received antibiotics. A negative rapid viral test was not associated with antibiotic prescription (aOR 1.2, 95% CI: 1.0-1.4). Conclusions. Rapid viral test usage did not reduce overall antibiotic prescription, whereas a positive rapid viral test did reduce antibiotic prescription at the ED. Implementation of rapid viral testing in routine emergency care and compliance to the rapid viral test outcome will reduce inappropriate antibiotic prescribing at the ED.

Publication metadata

Author(s): Tan CD, Hagedoorn NN, Dewez JE, Borensztajn DM, Von Both U, Carrol ED, Emonts M, Van Der Flier M, De Groot R, Herberg J, Kohlmaier B, Levin M, Lim E, MacOnochie IK, Martinon-Torres F, Nijman RG, Pokorn M, Rivero-Calle I, Strle F, Tsolia M, Vermont CL, Yeung S, Zachariasse JM, Zenz W, Zavadska D, Moll HA

Publication type: Article

Publication status: Published

Journal: Pediatric Infectious Disease Journal

Year: 2022

Volume: 41

Issue: 1

Pages: 39-44

Online publication date: 01/01/2022

Acceptance date: 26/07/2021

Date deposited: 08/03/2022

ISSN (print): 0891-3668

ISSN (electronic): 1532-0987

Publisher: Lippincott Williams and Wilkins


DOI: 10.1097/INF.0000000000003326


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