Evaluation of a molecular point-of-care testing for viral and atypical pathogens on intravenous antibiotic duration in hospitalized adults with lower respiratory tract infection: a randomized clinical trial

Duan, Shengchen; Gu, Xiaoqing; Fan, Guohui; Sun, Renhua; Wang, Y.; Yu, Donghao; Li, H.; Zhou, Fei; Xiong, Zhujia; Lu, Binghuai; Zhu, Guangfa; Cao, Bin

doi:10.1016/j.cmi.2019.06.012

Cited by 63 publications

(62 citation statements)

References 18 publications

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“…This present study is one of the several that have examined the application of FA‐RP in Asia . Compared with other published studies, our study focused on adults with more severe pneumonia conditions, and to the best of our knowledge, it is the only study that has covered two consecutive pandemic seasons.…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, it describes the positive clinical impacts of the FA‐RP, particularly in terms of antibiotic use. Similarly, Duan et al examined the use of the FA‐RP in the management of lower respiratory tract infections in a larger population in Beijing. A shorter length of hospitalization and a reduction in antibiotic use were observed.…”

Section: Discussionmentioning

confidence: 99%

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Rapid detection of respiratory organisms with FilmArray respiratory panel and its impact on clinical decisions in Shanghai, China, 2016‐2018

Qian

et al. 2019

Influenza Resp Viruses

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rapid detection of respiratory organisms with FilmArray respiratory panel and its impact on clinical decisions in Shanghai, China, 2016‐2018

Qian

et al. 2019

Influenza Resp Viruses

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“…US guidelines specifically recommend use of influenza and multiplex-PCR (mPCR) if these can change the management of hospitalized patients [2]. Patient benefit relies on rapid results turnaround time, and in this regard several kits are suitable for point of care (POC) use [3][4][5]. A few studies have investigated the impact of these tests on prescribing of antiinfectives and length of stay, and their potential cost-effectiveness [3,5].…”

Section: Sirmentioning

confidence: 99%

“…Patient benefit relies on rapid results turnaround time, and in this regard several kits are suitable for point of care (POC) use [3][4][5]. A few studies have investigated the impact of these tests on prescribing of antiinfectives and length of stay, and their potential cost-effectiveness [3,5]. However, none has focused on the impact of mPCR on infection prevention measures such as droplets precautions and single room allocation of hospitalized patients.…”

Section: Sirmentioning

confidence: 99%

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Multiplex PCR implementation as point-of-care testing in a French emergency department

Bouzid

Lucet

Duval

et al. 2020

Journal of Hospital Infection

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Community-Acquired Pneumonia

Vaughn,

Dickson,

Horowitz

et al. 2024

JAMA

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ImportanceCommunity-acquired pneumonia (CAP) results in approximately 1.4 million emergency department visits, 740 000 hospitalizations, and 41 000 deaths in the US annually.ObservationsCommunity-acquired pneumonia can be diagnosed in a patient with 2 or more signs (eg, temperature &gt;38 °C or ≤36 °C; leukocyte count &lt;4000/μL or &gt;10 000/μL) or symptoms (eg, new or increased cough or dyspnea) of pneumonia in conjunction with consistent radiographic findings (eg, air space density) without an alternative explanation. Up to 10% of patients with CAP are hospitalized; of those, up to 1 in 5 require intensive care. Older adults (≥65 years) and those with underlying lung disease, smoking, or immune suppression are at highest risk for CAP and complications of CAP, including sepsis, acute respiratory distress syndrome, and death. Only 38% of patients hospitalized with CAP have a pathogen identified. Of those patients, up to 40% have viruses identified as the likely cause of CAP, with Streptococcus pneumoniae identified in approximately 15% of patients with an identified etiology of the pneumonia. All patients with CAP should be tested for COVID-19 and influenza when these viruses are common in the community because their diagnosis may affect treatment (eg, antiviral therapy) and infection prevention strategies. If test results for influenza and COVID-19 are negative or when the pathogens are not likely etiologies, patients can be treated empirically to cover the most likely bacterial pathogens. When selecting empirical antibacterial therapy, clinicians should consider disease severity and evaluate the likelihood of a bacterial infection—or resistant infection—and risk of harm from overuse of antibacterial drugs. Hospitalized patients without risk factors for resistant bacteria can be treated with β-lactam/macrolide combination therapy, such as ceftriaxone combined with azithromycin, for a minimum of 3 days. Systemic corticosteroid administration within 24 hours of development of severe CAP may reduce 28-day mortality.ConclusionsCommunity-acquired pneumonia is common and may result in sepsis, acute respiratory distress syndrome, or death. First-line therapy varies by disease severity and etiology. Hospitalized patients with suspected bacterial CAP and without risk factors for resistant bacteria can be treated with β-lactam/macrolide combination therapy, such as ceftriaxone combined with azithromycin, for a minimum of 3 days.

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Evaluation of a molecular point-of-care testing for viral and atypical pathogens on intravenous antibiotic duration in hospitalized adults with lower respiratory tract infection: a randomized clinical trial

Cited by 63 publications

References 18 publications

Rapid detection of respiratory organisms with FilmArray respiratory panel and its impact on clinical decisions in Shanghai, China, 2016‐2018

Rapid detection of respiratory organisms with FilmArray respiratory panel and its impact on clinical decisions in Shanghai, China, 2016‐2018

Multiplex PCR implementation as point-of-care testing in a French emergency department

Community-Acquired Pneumonia

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