• M Echavarría, D N Marcone, M Querci, A Seoane, M Ypas, C Videla, C O'Farrell, S Vidaurreta, J Ekstrom, and G Carballal.
• Clinical Virology Unit, Centro de Educación Médica e Investigaciones Clínicas "CEMIC" - Consejo Nacional de Investigaciones Científicas y Técnicas "CONICET", Av. Galván 4102 (1431), Buenos Aires City, Argentina; Virology Laboratory, Centro de Educación Médica e Investigaciones Clínicas "CEMIC" - Consejo Nacional de Investigaciones Científicas y Técnicas "CONICET", Av. Galván 4102 (1431), Buenos Aires City, Argentina. Electronic address: mechavarria@cemic.edu.ar.
• J. Clin. Virol. 2018 Nov 1; 108: 90-95.

BackgroundAcute respiratory infections (ARI) are a leading cause of morbidity and mortality worldwide. There is a need to demonstrate the clinical impact of using the new, rapid and sensitive molecular assays in prospectively designed studies.ObjectivesTo study the impact on medical management of a rapid molecular assay in patients with respiratory infections.Study DesignA prospective, randomized, non-blinded study was performed in patients presenting to the Emergency Department during two respiratory seasons (2016-2017). Diagnosis was performed by FilmArray Respiratory Panel (FilmArray-RP) or by immunofluorescence assay (IFA).ResultsA total of 432 patients (156 children and 276 adults) were analyzed. Diagnosis with FilmArray-RP was associated with significant changes in medical management including withholding antibiotic prescriptions (OR:15.52, 95%CI:1.99-120.83 in adults and OR:12.23, 95%CI:1.56-96.09 in children), and reduction in complementary studies in children (OR:9.64, 95%CI:2.13-43.63) compared to IFA. Decrease in oseltamivir prescriptions was significantly higher in adults in the FilmArray-RP group (p = 0.042; OR:1.19, 95%CI:0.51-2.79) compared to adults managed with IFA. Diagnostic yield was significantly higher by FilmArray-RP (81%) than by IFA (31%)(p < 0.001). The median time from sample collection to reporting was 1 h 52 min by FilmArray-RP and 26 h by IFA (p < 0.001).ConclusionsThe high respiratory viruses' detection rate and availability of results within two hours when using FilmArray-RP were associated with decreases in antibiotic prescriptions and complementary studies and more accurate use of oseltamivir.Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

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