Pediatric Antibiotic Prescribing Remains High in ED, Despite Testing


New data highlight the need for more antimicrobial stewardship adoption in emergency care settings.

Access to and knowledge of rapid respiratory pathogen (RRP) testing capability in pediatric emergency department (ED) settings is actually associated with an increased likelihood of antibiotic prescribing, according to surprising new findings presented at IDWeek 2020.

The study, presented by Suchitra Rao, MBBS, MSCS, Associate Professor of the University of Colorado School of Medicine, showed a 12 percentage-point increase in antibiotic prescribing among children who test negative for a virus on an RRP test.

The findings—which come at a time when pediatric respiratory illness has become a more frequent reason for ED visit, as well as a driver of antibiotic prescription—warrant further understanding as to how available testing is associated with even greater likelihood of antibiotic use.

That said, RRP testing was also linked to appropriate levels of pediatric antiviral prescribing, ED length of stay, and hospitalization.

In an interview with Contagion during IDWeek, Rao discussed the “paradoxical” findings presented by her team.

“Most of the studies in hospitalized children shows that knowing about respiratory panel testing can decrease antibiotic testing, and this showed the opposite,” Rao said.

Rao also discussed the potential need for incorporated antimicrobial stewardship guidance alongside available infection testing in emergency settings, to assure work being done in the stewardship field is not undone.

Watch the full interview with Rao in the video above.

The poster, “The RAPID trial: randomized Controlled Trial assessing point-of-care influenza and Other Respiratory Virus diagnostics in the Pediatric ED Setting,” was presented at IDWeek 2020.

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