1858. The Impact of Molecular Testing on Antibiotic Utilization in Community-acquired Pneumonia
Session: Poster Abstract Session: Antibiotic Stewardship: Diagnostics
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • Blatt Molecular Testing ID Week 2016 Poster1.pptx 091916.pdf (498.0 kB)
  • Background: : Diagnostic testing for respiratory viruses can guide antimicrobial therapy and improve patient care. The study objective was to evaluate antibiotic therapy in patients with community-acquired pneumonia (CAP) who were tested for respiratory viruses via a respiratory virus PCR panel (RVP). Additionally the study evaluated patient characteristics and outcomes associated with viral pneumonia.

    Methods: Patients hospitalized at TriHealth with a diagnosis of CAP and who underwent molecular testing for respiratory viruses were included in the study. Patients with CAP who tested positive for viral pathogens on the RVP were compared to patients who tested negative to identify any differences in antibiotic days, patient characteristics, and patient outcomes.

    Results: The study included 190 subjects of which 108 (57%) tested positive and 82 (43%) tested negative for viral pathogens. Patients who tested positive had a lower creatinine level (p=.01), were younger (p=.04) and were less likely to have leukocytosis (p = .001). Although significantly fewer patients who tested positive took antibiotics for more than 2 days when compared to negative patients (p=.002), substantial antibiotic overuse was still demonstrated as the vast majority of patients who test positive on the RVP (72%) continued on antibiotic treatment for more than 2 days. There was not a significant difference in cumulative antibiotic days between patients who tested positive for viral pneumonia (4.0 median days) versus patients who tested negative for viral pneumonia (3.0 median days) (p=.56). Patient outcomes were similar between the two groups.

    Conclusion: These study results suggest that respiratory viral testing is having a minimal impact on reducing unnecessary antibiotic treatment. Viral pneumonia is associated with a lower prevalence in the elderly population and is less likely to be associated with leukocytosis. Additional biomarkers such as procalcitonin may need to be combined with molecular testing for respiratory viruses in order to assist physicians in the decision to discontinue antibiotic therapy in CAP.

    Stephen Blatt, MD, Internal Medicine, Good Samaritan Hospital, Cincinanti, OH, Aleksandr Yultyev, MD, Good Samaritan Hosptial, Cincinnati, OH, Miao Huang, MD, Internal Medicine, Good Samaritan Hospital, Cincinnati, OH and Jenni Steinbrunner, BS, Trihealth Hatton Research Institute, Good Samaritan Hospital, Cincinnati, OH

    Disclosures:

    S. Blatt, None

    A. Yultyev, None

    M. Huang, None

    J. Steinbrunner, None

    Previous Abstract | Next Abstract >>

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.