Use of point of care molecular tests reduces hospitalization and oseltamivir administration in children presenting with influenza like illness.

Dimopoulou, Dimitra; Vourli, Sophia; Douros, Konstantinos; Pournaras, Spyridon; Papaevangelou, Vassiliki

INTRODUCTION Influenza is associated with increased morbidity, health care costs, hospitalization rates and mortality in children. Rapid immuno-chromatography assay (ICA), a test with low sensitivity, is often used as point of care (POC) test. Recently, the rapid syndromic molecular test FilmArray, became available. This observational study aims to evaluate whether the use of FilmArray would decrease the use of antivirals and hospitalization rates among children presenting to the emergency room (ER) with influenza-like-illness (ILI) symptoms. MATERIALS AND METHODS Nasopharyngeal swabs were prospectively collected from children 0-16 years presenting with ILI at the ER of a tertiary hospital during the peak endemic period. Patients were allocated to be tested by either FilmArray or ICA. Use of antivirals and hospitalization rates were noted. Logistic regression models were used to investigate the impact of testing methods on decision making. RESULTS Overall, 80 children were included (mean age: 5 years). Admissions were more likely to occur if ICA test was performed (OR:3.16, 95%CI: 1.01-9.82, p=0.046). Oseltamivir administration was more likely among children who had undergone the ICA test (OR: 4.67, 95%CI: 1.06-20.43, p=0.041). The implementation of rapid molecular test had no impact on complementary diagnostic testing or antibacterial prescription. CONCLUSIONS The use of FilmArray significantly reduced both hospitalization and oseltamivir administration in children. Further education on the use of POC tests is needed to improve current management of children presenting with ILI and decrease associated health care costs. This article is protected by copyright. All rights reserved.