Impact of PCR for respiratory viruses on antibiotic use: Theory and practice

Rationale for the study Real‐time polymerase chain reaction (PCR) for respiratory viruses is more sensitive, yet more expensive, than conventionally used direct immunofluorescence (DIF). We determined the impact of real‐time PCR, additional to DIF, on antibiotic prescription in ventilated children with lower respiratory tract infection (LRTI) at admission to the pediatric intensive care unit (PICU). Methods First, a multicenter survey study was performed. Subsequently, in a prospective study, children (≤5 years) with LRTI were tested at admission by DIF and PCR. Positive DIF results were reported at the end of the first working day. PICU physicians reported antibiotic treatment on the second working day. After informing them of the PCR result antibiotic treatment was reevaluated. Results The multicenter survey study (94 respondents) showed that PCR decreased antibiotic use (P