2011. Reaction of Clinicians to Positive Respiratory Viral Panels in Non-critically Ill Patients Without Bacterial Infection

BACKGROUND: Respiratory viral panels (RVPs) can detect multiple viral pathogens and give clinicians diagnostic confidence to discontinue antibiotics. However, relatively little is known about how these tests influence antibiotic prescribing in hospital settings. METHODS: This was a 26-month retrospective chart review of patients with positive RVPs. Hospitalized adults receiving antibiotics at the time of the RVP were included. Exclusion criteria were: ICU care, solid-organ transplantation (SOT), positive RVP for influenza, positive bacterial cultures, and antibiotic administration for bacterial infection (e.g., cellulitis). A multivariate linear regression model was created to investigate associations with longer antibiotic use after a positive RVP. RESULTS: 1,346 patients were screened and 242 met inclusion criteria. Primary reasons for exclusion were SOT, ICU, and influenza diagnosis. Patients were a median age of 60.5 years [IQR 51,70] and 35.5% were men. The median length of stay (LOS) was 4 days [IQR 3.6]. 233 patients (6.3%) had chest radiology performed, of which 71 (30.4%) had possible pneumonia noted. 50 (20.7%) were immunocompromised (IC). 199 (82.2%) had a history of pulmonary disease, most commonly COPD. Rhinovirus was isolated in 156 patients (64.5%), followed by metapneumovirus (35, 14.9%) and RSV (32, 13.3%). Antibiotics were given for a median total of 3 days [IQR 3.6]; they were discontinued within 24 hours of the RVP result in 107 patients (44.2%). CONCLUSION: In this population of patients with viral infection and no discernable bacterial infection, 44.2% of patients had antibiotics discontinued within 24 hours of RVP results. On multivariate linear regression analysis, younger age, longer LOS, and IC status were associated with longer antibiotic duration after a positive RVP. A comparison with patients with negative RVP results could reveal if the test prompted discontinuation. [Image: see text] DISCLOSURES: All authors: No reported disclosures.