Antibiotic use in children is not influenced by the result of rapid antigen detection test for the respiratory syncytial virus

BackgroundRapid antigen detection test (RADT) for respiratory syncytial virus (RSV) is widely used in children hospitalized with acute respiratory tract infection (ARTI), but its influence on antibiotic (AB) use is uncertain.ObjectiveTo evaluate if confirmation of RSV infection by RADT modified AB use and elucidate others factors associated with the continuation of antibiotics.Study designCharts of children hospitalized with viral ARTI aged 0–35 months were reviewed. Modification of antibiotics according to RSV RADT results was compared using Kaplan–Meier estimates and multivariate Cox regression.ResultsOf children receiving antibiotics when the RSV RADT result was available, RSV RADT was positive in 144 and negative in 54. Positive RSV RADT results did not lead to modification of antibiotic use. Factors independently associated with cessation of intravenous antibiotics were age ≥ 3 months (HR 2.44 [1.41–4.21]) and absence of pneumonia (HR 1.50 [1.03–2.19]). Absence of otitis was associated with cessation of oral antibiotics (HR 9.16 [95% CI, 2.35–35.76]).ConclusionConfirmed presence of RSV by RADT did not influence antibiotic use in young children with ARTI. Except with pneumonia, the risk of bacterial superinfection of RSV infected children is minimal and confirmation of RSV infection should prompt treating physicians to interrupt antibiotics.