A retrospective analysis of the impact of FilmArray respiratory panel utilization on the management of pediatric asthma exacerbations

1(Farber) Bland S, 1Barcroft M, 2Hughes A, 2Turner K, 2Sahhar H
1Edward Via College of Osteopathic Medicine- Carolinas Campus, Duncan, SC, United states; 2Spartanburg Regional Healthcare System, Spartanburg, SC, United states

In the pediatric population, the most common reason for hospital admission is asthma exacerbation, which is often associated with a concomitant respiratory infection [2]. Rapid diagnostic testing, for bacterial and viral pathogens, has shown to decrease the duration of hospital stay and improve antibiotic utilization in patients with respiratory tract infections [3]. However, the impact of rapid testing in the setting of asthmatic patients has yet to be well defined. A common rapid diagnostic test used in the hospital setting is a FilmArray respiratory panel, which serves to detect seventeen respiratory viruses and three bacterial agents through PCR technique [1]. While this testing modality is effective and specific, it also comes with a high cost. In this study, we aim to optimize the use of the FilmArray panel, determining the patient population that would best benefit from its usage.

This single-center, retrospective, observational study will be conducted by reviewing pediatric patients who were diagnosed with an asthma exacerbation and admitted to the general pediatrics unit or pediatric intensive care unit over a fourteen-month timespan. Patients will be stratified into two cohorts: those in whom a FilmArray respiratory panel was performed and those who did not receive this diagnostic modality. Patients will be identified through data management software, with the following data analyzed: age, duration of antibiotic therapy, pathogens identified on FilmArray, hospital length of stay, asthma exacerbation severity, duplicate diagnostic tests ordered and corresponding result, and hospital costs.

Utilizing expensive diagnostic tests aids in confirming etiologies of acute illnesses such as upper respiratory infections and asthma exacerbations, however the majority of treatments are not altered by the results. In contrast, when a bacterial pathogen is suspected these laboratory tests provide a benefit in applying appropriate treatments in a timely manner. We hope to categorize patients based on the above data in an effort to provide recommendation of the appropriate population in whom to apply the FilmArray diagnostic tool. In addition, by optimizing the use of a highly expensive diagnostic test, we hope to decrease overall healthcare costs for both the patient and the institution.

1. Azadeh, Natalya, et al. “FilmArray Respiratory Panel Assay: Comparison of Nasopharyngeal Swabs and Bronchoalveolar Lavage Samples.” Journal of Clinical Microbiology 53.12 (2015): 3784–3787. PMC. Web. Jan. 2018.
2. Murray CS, et al. “Study of modifiable risk factors for asthma exacerbations: virus infection and allergen exposure increase the risk of asthma hospital admissions in children.” Thorax 2006;61:376-382. PMC. Web. Jan. 2018.
3. Rappo, Urania et al. “Impact of Early Detection of Respiratory Viruses by Multiplex PCR Assay on Clinical Outcomes in Adult Patients.” Journal of Clinical Microbiology 54.8 (2016): 2096–2103. PMC. Web. Jan. 2018.