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Review
. 2022 Sep 3;11(9):1192.
doi: 10.3390/antibiotics11091192.

Point-of-Care and Rapid Tests for the Etiological Diagnosis of Respiratory Tract Infections in Children: A Systematic Review and Meta-Analysis

Giulia Brigadoi  1 , Andrea Gastaldi  2 , Marco Moi  1 , Elisa Barbieri  3 , Sara Rossin  4 , Annalisa Biffi  5   6 , Anna Cantarutti  5   6 , Carlo Giaquinto  3 , Liviana Da Dalt  4 , Daniele Donà  3
Affiliations
Review

Point-of-Care and Rapid Tests for the Etiological Diagnosis of Respiratory Tract Infections in Children: A Systematic Review and Meta-Analysis

Giulia Brigadoi et al. Antibiotics (Basel). .

Abstract

Fever is one of the most common causes of medical evaluation of children, and early discrimination between viral and bacterial infection is essential to reduce inappropriate prescriptions. This study aims to systematically review the effects of point-of-care tests (POCTs) and rapid tests for respiratory tract infections on changing antibiotic prescription rate, length of stay, duration of therapy, and healthcare costs. Embase, MEDLINE, and Cochrane Library databases were systematically searched. All randomized control trials and non-randomized observational studies meeting inclusion criteria were evaluated using the NIH assessment tool. A meta-analysis was performed to assess the effects of rapid influenza diagnostic tests and film-array respiratory panel implementation on selected outcomes. From a total of 6440 studies, 57 were eligible for the review. The analysis was stratified by setting and POCT/rapid test type. The most frequent POCTs or rapid tests implemented were the Rapid Influenza Diagnostic Test and film-array and for those types of test a separate meta-analysis assessed a significant reduction in antibiotic prescription and an improvement in oseltamivir prescription. Implementing POCTs and rapid tests to discriminate between viral and bacterial infections for respiratory pathogens is valuable for improving appropriate antimicrobial prescriptions. However, more studies are needed to assess these findings in pediatric settings.

Keywords: POCT; RIDT; antimicrobials; children; diagnostic stewardship; film-array.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study selection process (PRISMA).
Figure 2
Figure 2
Geographical distribution of articles included in this review.
Figure 3
Figure 3
The number of studies for each different outcome stratified by (A) settings; (B) countries; ED = emergency department.
Figure 4
Figure 4
Forest plot of prescription of antibiotics after implementation of FA-RP: (A) FA-RP vs. standard test; (B) FA-RP versus clinical diagnosis.
Figure 5
Figure 5
Forest plot of prescription of antibiotics after implementation of RIDT: (A) RIDT vs. clinical diagnosis; (B) RIDT positive versus RIDT negative; (C) RIDT positive vs. standard of care positive.
Figure 6
Figure 6
Forest plot of prescription of oseltamivir after implementation of FA-RP: (A) FA-RP vs. standard of care; (B) FA-RP vs. clinical diagnosis.
Figure 7
Figure 7
Forest plot of prescription of oseltamivir after implementation of RIDT: (A) RIDT vs. clinical diagnosis; (B) RIDT positive vs. RIDT negative; (C) RIDT positive vs. standard of care positive.
Figure 8
Figure 8
Risk of bias assessment with the different NIH tools for the different types of studies.
See this image and copyright information in PMC

References

    1. Sands R., Shanmugavadivel D., Stephenson T., Wood D. Medical problems presenting to paediatric emergency departments: 10 Years on. Emerg. Med. J. 2012;29:379–382. doi: 10.1136/emj.2010.106229. - DOI - PubMed
    1. Dellit T.H., Owens R.C., McGowan J.E., Gerding D.N., Weinstein R.A., Burke J.P., Huskins W.C., Paterson D.L., Fishman N.O., Carpenter C.F., et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. Clin. Infect. Dis. 2007;44:159–177. - PubMed
    1. Hecker M.T., Aron D.C., Patel N.P., Lehmann M.K., Donskey C.J. Unnecessary Use of Antimicrobials in Hospitalized Patients. Arch. Intern. Med. 2003;163:972–978. doi: 10.1001/archinte.163.8.972. - DOI - PubMed
    1. Messacar K., Gaensbauer J.T., Birkholz M., Palmer C., Todd J.K., Tyler K.L., Dominguez S.R. Impact of FilmArray meningitis encephalitis panel on HSV testing and empiric acyclovir use in children beyond the neonatal period. Diagn. Microbiol. Infect. Dis. 2020;97:115085. doi: 10.1016/j.diagmicrobio.2020.115085. - DOI - PMC - PubMed
    1. Samuel L. Point-of-Care Testing in Microbiology. Clin. Lab. Med. 2020;40:483–494. doi: 10.1016/j.cll.2020.08.006. - DOI - PubMed

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