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Evidence summaries

Rapid Viral Diagnosis for Acute Febrile Respiratory Illness in Children

In previously healthy children coming to the emergency department with fever and respiratory symptoms, a rapid viral test may reduce the use of chest X-rays and there seems to be a trend toward less antibiotic usage, and blood investigations. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 4 studies with a total of 1595 children. Rapid viral testing did not reduce antibiotic use in the emergency departments (EDs) significantly (RR 0.89, 95% CI 0.71 to 1.12; 4 studies, n=1590), neither clinically nor statistically. Lower rates of chest radiography (RR 0.77, 95% CI 0.65 to 0.91; 4 studies, n=1590) were found in the rapid viral testing group but no effect on length of ED visits (MD -10.6 min, 95% CI -22.5 to 1.25; 3 studies, n=1290), blood (RR 0.79, 95% CI 0.62 to 1.0; 4 studies, n=1590) or urine testing (RR 0.97, 95% CI 0.79 to 1.19; 4 studies, n=1588) in the ED.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment) and by imprecise results (limited study size for each comparison).

References

  • Doan Q, Enarson P, Kissoon N et al. Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department. Cochrane Database Syst Rev 2014;(9):CD006452. [PubMed]

Primary/Secondary Keywords