Hospital Pharmacy - October 2017 - 640

731573
research-article2017

HPXXXX10.1177/0018578717731573Hospital PharmacyChoi et al

Article

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

Hospital Pharmacy
2017, Vol. 52(9) 640-644
© The Author(s) 2017
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https://doi.org/10.1177/0018578717731573
DOI: 10.1177/0018578717731573
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Sebastian Choi1, Rubiya Kabir1, Pranisha Gautam-Goyal1,
and Prashant Malhotra1

Abstract
Background: Respiratory viral illnesses account for many hospitalizations and inappropriate antibiotic use. Respiratory
viral panels by polymerase chain reaction (RVP-PCR) provide a reliable means of diagnosis. In 2015, the RVP-PCR assay
at our institution was switched from respiratory viral panel (RVP) to rapid respiratory panel (rapid RP), which has a faster
turnaround time (24 hours vs 12 hours, respectively). The purpose of this study was to evaluate the effect of RVP-PCR tests
on duration of antibiotic use and length of stay (LOS) in hospitalized patients. Methods: We performed a retrospective
chart review of patients who had a RVP-PCR ordered within a 1-year time period before and after the assay switch. Patients
who were pregnant, had received antibiotics within 30 days prior to admission, were not discharged, or had not completed
antibiotics by end of study period were excluded. Results: Data were obtained from a total of 140 patients (70 in each
group). Of these, 25 (35.7%) in the RVP group and 28 (40.0%) in the rapid RP group had a positive result. The median LOS
was 4.5 days (IQR, 3-9 days) in the RVP group and 5 days (IQR, 3-9 days) in the rapid RP group (P = .78). The median
duration of antibiotic use was 4 days (IQR, 2-7 days) in the RVP group and 5 days (IQR, 1-7 days) in the rapid RP group (P
= .8). Conclusion: Despite faster turnaround time, there was no significant difference in duration of antibiotic use, or LOS
between the RVP and rapid RP groups.
Keywords
respiratory viral illnesses, respiratory viral panel, polymerase chain reaction, antibiotic use

Introduction
Early and accurate diagnosis of respiratory viral illnesses is
important because these are among the most common reasons for hospitalization and account for a large proportion of
inappropriate antibiotic use. Previous conventional methods
of diagnosing viral etiologies by cultures have shown to be
time-consuming and labor intensive, with poor sensitivity for
detection.1 The availability of respiratory viral panels by
polymerase chain reaction (RVP-PCR) has provided a reliable means of diagnosis and are rapid and sensitive compared with conventional methods.1
A small number of studies analyzed the impact of RVPPCR testing on clinical outcomes in pediatric populations.2-4 In these studies, limited data showed a decrease in
antibiotic usage and in length of stay (LOS) when compared with conventional methods of testing. While Schulert
et al showed that positive results of RVP testing were

associated with decreased duration of antibiotics and
decreased LOS in pediatric patients,2 other studies demonstrated that RVP may not be associated with these benefits
in pediatric pneumonia and cancer patients.3,4 In these studies, investigators considered a 24-hour turnaround time to
be rapid for RVP-PCR testing.
Although studies that compared sensitivity and turnaround times of different RVP-PCR tests have been conducted, data comparing the clinical outcomes associated
with these assays on antibiotic use and duration of hospitalization are scant.1,5 Earlier diagnosis of a viral infection with
1

North Shore University Hospital, Manhasset, NY, USA

Corresponding Author:
Sebastian Choi, Pharmacy Department, North Shore University Hospital,
300 Community Drive, Manhasset, NY 11030, USA.
Email: schoi10@northwell.edu
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