Author: Lee, Chien-Chang; Chang, Julia Chia-Yu; Mao, Xiao-Wei; Hsu, Wan-Ting; Chen, Shey-Ying; Chen, Yee-Chun; How, Chorng-Kuang
Title: Combining Procalcitonin and Rapid Multiplex Respiratory Virus Testing for Antibiotic Stewardship in Older Adult Patients With Severe Acute Respiratory Infection Cord-id: jf4j00bp Document date: 2019_11_30
ID: jf4j00bp
Snippet: OBJECTIVES: Virus infection is underevaluated in older adults with severe acute respiratory infections (SARIs). We aimed to evaluate the clinical impact of combining point-of-care molecular viral test and serum procalcitonin (PCT) level for antibiotic stewardship in the emergency department (ED). DESIGN: A prospective twin-center cohort study was conducted between January 2017 and March 2018. SETTING AND PARTICIPANTS: Older adult patients who presented to the ED with SARIs received a rapid molec
Document: OBJECTIVES: Virus infection is underevaluated in older adults with severe acute respiratory infections (SARIs). We aimed to evaluate the clinical impact of combining point-of-care molecular viral test and serum procalcitonin (PCT) level for antibiotic stewardship in the emergency department (ED). DESIGN: A prospective twin-center cohort study was conducted between January 2017 and March 2018. SETTING AND PARTICIPANTS: Older adult patients who presented to the ED with SARIs received a rapid molecular test for 17 respiratory viruses and a PCT test. MEASURES: To evaluate the clinical impact, we compared the outcomes of SARI patients between the experimental cohort and a propensity score–matched historical cohort. The primary outcome was the proportion of antibiotics discontinuation or de-escalation in the ED. The secondary outcomes included duration of intravenous antibiotics, length of hospital stay, and mortality. RESULTS: A total of 676 patients were included, of which 169 patients were in the experimental group and 507 patients were in the control group. More than one-fourth (27.9%) of the patients in the experimental group tested positive for virus. Compared with controls, the experimental group had a significantly higher proportion of antibiotics discontinuation or de-escalation in the ED (26.0% vs 16.1%, P = .007), neuraminidase inhibitor uses (8.9% vs 0.6%, P < .001), and shorter duration of intravenous antibiotics (10.0 vs 14.5 days, P < .001). CONCLUSIONS AND IMPLICATIONS: Combining rapid viral surveillance and PCT test is a useful strategy for early detection of potential viral epidemics and antibiotic stewardship. Clustered viral respiratory infections in a nursing home is common. Patients transferred from nursing homes to ED may benefit from this approach.
Search related documents:
Co phrase search for related documents- acute exacerbation and admission day: 1, 2
- acute exacerbation and admission diagnosis: 1
- acute exacerbation pulmonary disease and admission day: 1
- acute respiratory failure and additional information: 1, 2
- acute respiratory failure and admission day: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25
- acute respiratory failure and admission diagnosis: 1, 2, 3, 4
- acute respiratory failure and admission ed: 1, 2
- acute respiratory illness and additional information: 1, 2, 3
- acute respiratory illness and admission day: 1, 2, 3, 4, 5
- acute respiratory illness and admission diagnosis: 1, 2, 3, 4, 5
- acute respiratory illness and admission ed: 1
- acute respiratory infection and additional information: 1, 2, 3, 4, 5, 6, 7, 8
- acute respiratory infection and admission day: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25
- acute respiratory infection and admission diagnosis: 1, 2, 3, 4, 5, 6, 7, 8, 9
- acute respiratory infection and admission ed: 1, 2, 3, 4, 5, 6
- acute severe respiratory illness and additional information: 1, 2, 3
- acute severe respiratory illness and admission day: 1, 2, 3
- acute severe respiratory illness and admission diagnosis: 1
Co phrase search for related documents, hyperlinks ordered by date