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Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department

Doan Q, Enarson P, Kissoon N, Klassen TP, Johnson DW

The Cochrane database of systematic reviews, 2012

759 participants

Abstract

BACKGROUND: Pediatric acute respiratory infections (ARIs) represent a significant burden on pediatric Emergency Departments (EDs) and families. Most of these illnesses are due to viruses. However, investigations (radiography, blood, and urine testing) to rule out bacterial infections and antibiotics are often ordered because of diagnostic uncertainties. This results in prolonged ED visits and unnecessary antibiotic use. The risk of concurrent bacterial infection has been reported to be negligible in children over three months of age with a confirmed viral infection. Rapid viral testing in the ED may alleviate the need for precautionary testing and antibiotic use.

OBJECTIVES: To determine the effect of rapid viral testing in the ED on the rate of precautionary testing, antibiotic use, and length of ED visit.

SEARCH METHODS: We searched the Cochrane Central register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4); EMBASE (1988 to December 2011); MEDLINE Ovid (1950 to November week 4, 2011); MEDLINE In-Process & Other Non-Indexed Citations (8 December 2011); HealthStar (1966 to 2009); BIOSIS Previews (1969 to December 2011); CAB Abstracts (1973 to December 2011); CBCA Reference (1970 to 2007); and Proquest Dissertations and Theses (1861 to 2009).

SELECTION CRITERIA: Randomized controlled trials (RCTs) of rapid viral testing for children with ARIs in the ED.

DATA COLLECTION AND ANALYSIS: Two review authors used the inclusion criteria to select trials,…

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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 759 participants or records.

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