Clinical outcomes of rapid respiratory virus testing in emergency departments: A systematic review and meta-analysis

Analysis of 11 RCTs (n=6068) found rapid viral testing in suspected acute respiratory infection did not reduce antibiotic use or duration of hospital stay. Testing led to increased influenza antiviral use (+ 1%) and decreased chest radiography and blood tests (- 3% and 4%).

SPS commentary:

A related editorial discusses rapid tests. These include pathogen-specific monoplex polymerase chain reaction tests, multiplex polymerase chain reaction tests that test for multiple pathogens simultaneously and viral antigen tests.

It notes that, although the analysis did not report an overall reduction in antibiotic use, it showed a reduction in those with rapid positive test results for influenza. This was counterbalanced with increased antibiotic use in those with a negative test result.  It is also notable that all of the studies included in this systematic review and meta-analysis were conducted before the start of COVID-19 pandemic, and only 16% of the population were adults.

It concludes that rapid viral tests should be used judiciously as there remains a need to build high-quality evidence to identify at-risk populations for whom these tests are most informative, efficient, and cost effective.

JAMA Internal Medicine

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Editorial