PracticeUpdate Conference Series: ERS 2018

" ...unnecessary antibiotics were avoided in 50% of patients and hospital admission was avoided in 25% of patients. Of those who avoided hospital admission and were not prescribed antibiotics, none experienced adverse clinical outcomes. "

infection, particularly in patients with chronic obstructive pulmonary disease. In 387 patients, test results were com- bined with other important clinical factors, such as chest x-ray findings and lack of evidence of bacterial infection. According to Dr. Roy, bed flow was improved and fewer bed closures were required as a result of viral infections when patients underwent this respiratory viral testing shortly following admission to the emergency department. She also noted that 50 cases of influenza were diagnosed in the first 2 weeks of this new service. Of these cases, 22 were diagnosed in the emergency depart- ment and 28 were diagnosed following hospital admission. Importantly, no bed moves were needed in the former group, whereas 14 were needed in the latter group. Dr. Roy noted that infection control was improved through earlier testing at the bedside in the emergency department, which also avoided bed and ward

closures and reduced the risk of infection spreading to more vulnerable patients. If admission is required, patients with an early influenza diagnosis based on point-of-care respiratory viral testing can be placed in designated beds. Importantly, the use of this test seems to provide a net cost saving by avoid- ing unnecessary admission in patients who otherwise would be admitted and prescribed antibiotics while waiting approximately 2 days for lab results, according to Dr. Roy. Dr. Roy is about to begin a randomized controlled trial in the community, in which

primary care physicians will refer patients to point-of-care respiratory viral testing. According to Dr. Roy, good antimicrobial stewardship has been hindered based on the frequent underestimation of the importance of viruses in respiratory admissions, which has resulted in other health problems such as inappropriate antibiotic use and hospital admission. She concluded by noting that the hope is that point-of-care respiratory viral testing can improve quality of care and reduce anti- biotic resistance.

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ERS 2018 • PRACTICEUPDATE CONFERENCE SERIES