PracticeUpdate Conference Series: ERS 2018

50-Minute Test for Viral Infections Reduces Hospital Admissions and Antibiotic Use The test can reduce unnecessary antibiotic use and hospital admissions.

A 50-minute viral test could save hospitals approximately €2500 per patient not admit- ted to hospital and could help relieve winter pressure for available beds. It may also help reduce antibiotic resistance, results of a trial including over 1000 patients report. According to Kay Roy, MD, of West Hertfordshire Hospitals National Health Service Trust, Watford, and the University of Hertfordshire in Hatfield, UK, the potential of this test was revealed through initial results of the first 1075 patients. Of these patients, 121 had viral infections, lacked evidence of bacterial infection, and had normal chest x-rays and modest inflammatory markers. Dr. Roy also noted that 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.

She also explained that the process, including obtaining the sample and receiving the result, should take 50 minutes or less. This quick turna- round may have an enormous impact on the quality of care patients receive. The patient journey will be improved through ear- lier patient management decision making with the shortened test time. Dr. Roy noted that this is the same technology used in the microbiology labo- ratory, but now the equipment is at the bedside. When samples are sent to the microbiology lab, more than 2 days may be required for analysis and reporting of the results. A swab is inserted into the patient’s nostril to collect a secretion sample from the back of the nose (1 minute). The sample is then prepared and inserted into the compact FilmArray® machine (3–5 minutes). The machine analyzes the sample and prints results within 43 minutes. Of the first 1075 patients who underwent the testing, 61% were found to harbor one or more viruses, of which 56% were influenza and 54%, other viruses such as rhinovirus, coronavirus, metapneumovirus, and adenovirus. These can cause as many respira- tory and other problems as influenza or bacterial

© ERS 2018

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PRACTICEUPDATE CONFERENCE SERIES • ERS 2018