Abstract Category: Research
Purpose: Historically, respiratory pathogen testing has included the use of cultures and antigen-testing. Introduction of rapid polymerase chain reaction (PCR) assay has resulted in fast, effective identification of viral pathogens. However, studies show conflicting findings in the usefulness of PCR technology in the management of respiratory infections. The objective of this study is to examine the use of viral PCR assays in the management of respiratory viral infections in a community hospital. The study will describe viral PCR use in identifying viral pathogens, evaluating appropriate treatment, and de-escalating of antimicrobial therapy when indicated.
Methods: Patients will be identified from daily molecular result reports provided to the pharmacy. Admitted patients 18 years of age or older who received viral respiratory PCR testing between July 1, 2017 and March 31, 2018 will be randomly selected for study inclusion. Patients who do not meet the inclusion criteria or have a documented respiratory infection treatment within two weeks prior to the time of admission will be excluded. Data collected will include viral PCR results, diagnostic labs, time of PCR result, time of initial antimicrobial treatment, and time of therapy modification.
Findings: Preliminary data demonstrates that 26.7% (16/60) of the patients who had PCR assay testing were determined to be positive for a respiratory viral infection. The most commonly reported virus in this group was rhinovirus/enterovirus (10/16, 62.5%). Additionally, data also reveals that in addition to the rapid PCR assays, approximately 1 in every 3 patients received an influenza A and B antigen test (18/60, 30%) and 61.7% (37/60) had a procalcitonin level. Furthermore, all of the patients who tested positive for a respiratory viral infection were managed appropriately taking into account any co-infection. The antimicrobial de-escalation time when antimicrobial therapy was not indicated was approximately 4 hours.
Discussion: Research in progress
Implications for Practice: This study will demonstrate the role of rapid polymerase chain reaction assays as a diagnostic tool for respiratory viral infections and their role in antimicrobial therapy management. The results of the study will highlight the importance of reducing unnecessary diagnostic testing in the setting of respiratory viral infections. Additionally, this study will evaluate the appropriateness of initial antimicrobial treatment as well as the time to therapy optimization upon PCR results.
2018 West Kendall Baptist Hospital Scholarly Showcase
Deandra Romero - Pharmacy Resident PGY 1
Romero, Deandra; Lopez-Samblas, Ana; and Rojo-Carlo, Maria, "Examining the Use of Rapid Polymerase Chain Reaction Assay in Optimizing Antimicrobial Usage in Respiratory Viral Infections" (2018). All Publications. 2748.
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