Effect of rapid diagnosis of influenza virus type A on the emergency department management of febrile infants and toddlers

被引:100
作者
Sharma, V
Dowd, MD
Slaughter, AJ
Simon, SD
机构
[1] Childrens Mercy Hosp, Dept Pediat, Kansas City, MO 64108 USA
[2] Childrens Mercy Hosp, Dept Informat Serv, Kansas City, MO 64108 USA
[3] Univ Missouri, Sch Med, Kansas City, MO 64108 USA
来源
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE | 2002年 / 156卷 / 01期
关键词
D O I
10.1001/archpedi.156.1.41
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Evidence shows that the rapid detection of influenza using an enzyme-linked immunosorbent assay decreases antibiotic use in the treatment of pediatric patients. To our knowledge, the effect on other diagnostic testing in an emergency department (ED) has not been examined. Objective: To determine the effect of rapid diagnosis of influenza virus type A on the clinical management of febrile infants and toddlers in a pediatric ED at an urban children's hospital. Materials and Methods: A retrospective review of ED records from an electronic database was performed. All children 2 to 24 months of age, with a temperature higher than 39degreesC who had a positive influenza virus type A test result using an enzyme-linked immunosorbent assay from November 1, 1998, through April 30, 2000 (n = 72), were included in this study. Two groups were compared-those who had positive test results reported before discharge from the ED (early diagnosis) and those who had positive test results after discharge (late diagnosis). Results: Forty-seven patients (65%) were in the early diagnosis group and 25 (35%) in the late diagnosis group. The groups were similar for age, temperature, and triage category. Fewer patients in the early diagnosis group received ceftriaxone sodium compared with those in the late diagnosis group (2% vs 24%, P=.006); there were fewer urinalyses (2% vs 24%, P =.006) and complete blood cell counts performed (17% vs 44%, P=.02). Conclusions: Rapid confirmation of influenza virus type A infection seems to decrease ancillary tests and antibiotic use in febrile infants and toddlers in the ED. A prospective study with a larger group is needed to confirm these findings.
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页码:41 / 43
页数:3
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