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. 2023 Jun 8;76(11):1942-1948.
doi: 10.1093/cid/ciad038.

The Influence of Rapid Influenza Diagnostic Testing on Clinician Decision-Making for Patients With Acute Respiratory Infection in Urgent Care

Brian D Stamm  1   2 , John Tamerius  3 , Sush Reddy  3 , Shari Barlow  2 , Caroline Hamer  2 , Ashley Kempken  2 , Maureen Goss  2 , Cecilia He  2 , Cristalyne Bell  2 , Mitchell Arnold  2 , Mary Checovich  2 , Emily Temte  2 , Derek Norton  2 , Guanhua Chen  2 , Jeffrey Baltus  2 , Emily S Gurley  1 , Jonathan L Temte  2
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The Influence of Rapid Influenza Diagnostic Testing on Clinician Decision-Making for Patients With Acute Respiratory Infection in Urgent Care

Brian D Stamm et al. Clin Infect Dis. .

Abstract

Background: The potential benefits of using rapid influenza diagnostic tests (RIDTs) in urgent care facilities for clinical care and prescribing practices are understudied. We compared antiviral and antibiotic prescribing, imaging, and laboratory ordering in clinical encounters with and without RIDT results.

Methods: We compared patients with acute respiratory infection (ARI) symptoms who received an RIDT and patients who did not at 2 urgent care facilities. Primary analysis using 1-to-1 exact matching resulted in 1145 matched pairs to which McNemar 2 × 2 tests were used to assess the association between the likelihood of prescribing, imaging/laboratory ordering, and RIDT use. Secondary analysis compared the same outcomes using logistic regression among the RIDT-tested population between participants who tested negative (RIDT(-)) and positive (RIDT(+)).

Results: Primary analysis revealed that compared to the non-RIDT-tested population, RIDT(+) patients were more likely to be prescribed antivirals (OR, 10.23; 95% CI, 5.78-19.72) and less likely to be prescribed antibiotics (OR, 0.15; 95% CI, .08-.27). Comparing RIDT-tested to non-RIDT-tested participants, RIDT use increased antiviral prescribing odds (OR, 3.07; 95% CI, 2.25-4.26) and reduced antibiotic prescribing odds (OR, 0.52; 95% CI, .43-.63). Secondary analysis identified increased odds of prescribing antivirals (OR, 28.21; 95% CI, 18.15-43.86) and decreased odds of prescribing antibiotics (OR, 0.20; 95% CI, .13-.30) for RIDT(+) participants compared with RIDT(-).

Conclusions: Use of RIDTs in patients presenting with ARI symptoms influences clinician diagnostic and treatment decision-making, which could lead to improved patient outcomes, population-level reductions in influenza burden, and a decreased threat of antibiotic resistance.

Keywords: acute respiratory infection; antibiotic resistance; antiviral and antibiotic prescribing; influenza; rapid influenza diagnostic test.

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Conflict of interest statement

Potential conflicts of interest. J. T. and S. R. are employed by the Quidel Corporation. J. L. T. received research support from the Quidel Corporation. G. C. reports grants or contracts from the National Institutes of Health, Patient-Centered Outcomes Research Institute, and the American Cancer Society. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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References

    1. Nair H, Brooks WA, Katz M, et al. . Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. Lancet 2011; 378:1917–30. - PubMed
    1. World Health Organization . Influenza (seasonal). Available at: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal). Accessed 28 October 2021.
    1. Dobson J, Whitley RJ, Pocock S, Monto AS. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet 2015; 385:1729–37. - PubMed
    1. Monto AS. The role of antivirals in the control of influenza. Vaccine 2003; 21:1796–800. - PubMed
    1. Smith JR, Ariano RE, Toovey S. The use of antiviral agents for the management of severe influenza. Crit Care Med 2010; 38:e43–51. - PubMed

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