Impact of Respiratory Viral Panel Polymerase Chain Reaction (RVP-PCR) Assay Turnaround Time on Length of Stay and Antibiotic Use in Patients With Respiratory Viral Illnesses

Abstract

Background. Respiratory viral illnesses are among the most common reason for hospitalization and account for a large proportion of inappropriate antibiotic use. The availability of respiratory viral panel by polymerase chain reaction (RVP-PCR) has provided a reliable means of diagnosis. The primary objective of this study was to evaluate the effect of RVP-PCR tests with rapid turnaround times on duration of antibiotic use and length of stay (LOS) in the hospitalized patients. Methods. In January 2015, the RVP-PCR assay at our institution was switched from respiratory viral panel (RVP) by Luminex xTag to rapid respiratory panel (rapid RP) by BioFire FilmArray. The turnaround time for the rapid RP assay was shorter (12 hours) compared with the RVP assay (24 hours). We performed a retrospective chart review of electronic medical records of patients (18 years or older) who had a RVP-PCR ordered within a 1-year time period before or after the assay switch. Patients who were pregnant, had received antibiotics within 30 days of admission, were not discharged by end of study period, or had not completed antibiotics by end of study period, were excluded. Data obtained included baseline demographics, antibiotic use, LOS, and lab results including cultures. The Mann-Whitney U test and Fisher's exact test were used for continuous and categorical factors, respectively. Statistical analysis was completed using SAS version 9.4 (Cary, NC). Results. Data were obtained from a total of 140 patients (70 each in the RVP and rapid RP group). Of these, 25 (35.7%) in the RVP group and 28 (40.0%) in the rapid RP group had a positive RVP-PCR. Baseline characteristics were similar except for a higher percentage of immunocompromised patients in the RVP group (35.7% versus 18.6%; p = 0.036). Primary outcomes are shown in table 1. Conclusion. Despite faster turnaround time, we observed no statistically significant difference in duration of antibiotic use or LOS between RVP and rapid RP groups. Small sample size, confounding variables, and a small difference of 12 hours between turnaround times, may have contributed to this result. (Table Presented) .