{
  "abstract": "Background The utility of a PCR-based respiratory virus panel (RVP) in limiting antibiotic overuse in paediatric febrile and respiratory illnesses in low- and middle-income countries remains unclear.Methods This retrospective study included inpatients who underwent RVP testing within 48 hours of admission between January 2021 and December 2022. The primary outcome was the impact of the respiratory viral panel result on total duration of antibiotics. The secondary outcome was discontinuation of antibiotics following test results and duration of antibiotics in specific subgroups. A zero-inflated negative binomial (ZINB) regression identified predictors of outcome.Results Of the 210 cases, 152 (72.3%) tested positive for ≥1 virus. 42% of patients had their antibiotics discontinued after getting a positive result. Overall, we noted a minimal effect of a positive RVP result in reducing antibiotic utilisation. However, in influenza patients, we observed a significant decrease in median antibiotic days compared with those with negative RVP (3 days (IQR 0–5.5) vs 6 days (IQR 2.25–8); p=0.011). Patients with acute febrile illness with viral aetiology received fewer days of antibiotics compared with those with negative RVP (2.5 days (IQR 0–5) vs 5 days (IQR 2–7); p=0.035). ZINB regression analysis showed that pneumonia patients (OR=1.27; p=0.03) and those with paediatric intensive care unit stay (1.2; 0.02) had higher odds of prolonged antibiotic use despite RVP positivity.Conclusion In our setting, RVP reduced antibiotic use in specific subgroups like influenza-positive patients and those with acute febrile illness and could be potentially used as an antibiotic stewardship tool in these settings.",
  "authors": [
    {
      "affiliations": [
        "Department of Pediatric Infectious Diseases, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Praveena Nediyara Bhaskaran"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Merlin Moni"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Dipu T T Sathyapalan"
    },
    {
      "affiliations": [
        "Virology Laboratory, Molecular Diagnostics Laboratory, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Soumya Jose"
    },
    {
      "affiliations": [
        "Virology Laboratory, Molecular Diagnostics Laboratory, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Ajai Krishna"
    },
    {
      "affiliations": [
        "Virology Laboratory, Molecular Diagnostics Laboratory, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Lima Rose"
    },
    {
      "affiliations": [
        "Virology Laboratory, Molecular Diagnostics Laboratory, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Asha Sudheer"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Kiran Kishore"
    },
    {
      "affiliations": [
        "Virology Laboratory, Molecular Diagnostics Laboratory, Amrita Vishwa Vidyapeetham, Amrita Health Sciences Campus, Kochi, Kerala, India"
      ],
      "name": "Veena Menon"
    }
  ],
  "title": "Impact of multiplex PCR respiratory viral panel testing on antibiotic utilisation in children with acute febrile and respiratory illnesses",
  "uid": "1fd4ea6c-65bf-53ba-a468-2f464bddb79f"
}