Dr Ruchir Chavada1, Dr Liam Clifford2, Dr Owen Weisback2
1NSW Health Pathology, Gosford , Australia, 2Department of Medicine,Gosford/Wyong Hospital, Gosford , Australia
Despite availability of several rapid Influenza tests(RIT), literature on its impact on antimicrobial stewardship programs(AMS) is minimal. Studies utilising respiratory virus PCR have shown benefit in terms of shortening antimicrobial therapy and hospital length of stay(LOS). We designed this study to assess whether RIT had an impact on antibiotic cessation.
Xpert Flu/RSV (Cepheid, CA) was done on all patients who presented with influenza like illness(ILI) in 2017. Clinical data was collected from electronic medical records(eMR). Patients with RSV were not included. Turnaround time(TAT) for test was time from specimen collection until when result was either notified or appeared on eMR. Standard univariate analysis and multivariable regression analysis(MVRA) were done.
A total of 665 patients tested positive-Influenza A (63%) and B (37%). After positive results, antimicrobials were ceased in 34% (226/665) or not given in 10% (71/665) cases. Median TAT was 7 hours with 50% of tests completed in ≤ 6hours. 56%(368/665) of patients had their antibiotics continued. On MVRA, results of Flu PCR that were available in ≤ 12 hours resulted in most antibiotic cessation (73%, OR 1.55, p=0.011). It was found that antibiotics are continued in immunosuppressed patients (OR 2.88, p=0.002), pneumonia (OR 18.8, p<0.001) and COPD (OR 2.43, p=0.001).
In patients with ILI antibiotics are more likely to be continued when there is underlying COPD, pneumonia, or immunosuppression. In our hospitals, RIT done with a TAT of ≤12 hours was shown to avoid unnecessary antibiotic therapy, thus helping with AMS initiatives.
Biography submitted with other abstract