INTRODUCTION OF VIRAL PCR DIAGNOSTICS IN PEDIATRIC RESPIRATORY TRACT INFECTION: EFFECS ON TREATMENT AND COSTS

Respiratory infections are encountered frequently in children. They account for
nearly 10% of the emergency visits and 20% of all pediatric hospital
admissions. The majority is of viral origin. At least 12 different virusses are
known to cause respiratory infection in children. All these virusses can be
detected with PCR techniques. The PCR results can be generated within 48 hours,
thereby
potentially influencing the treatment strategy. By introducing these
techniques, diagnostic costs may increase tremendously. Whether these
diagnsotic PCR-results are essential in clinical decision making is
questionable. In respiratory infection the role of the micro-organism is
overestimated. Other patient characteristics are important to tailor individual
treatment.

Impact of introduction of real-time viral PCR on clinical decision making and
costs in children with a respiratory tract infection.

Randomized Clinical Trial
A cohort of 600 children is recruited in a peripheral teaching hospital
(Reinier de Graaf Groep, Delft) and an university hospital (ErasmusMC - Sophia)
during the first 2 years of the study. Clinical data are collected at entry of
the study by case record forms. The children will be randomized in 2 arms.
Treating physicians in arm A will receive the information of the PCR
diagnostics within 48 hours. Treating physicians in arm B will receive the
information of the PCR diagnostics after 4 weeks.
The 2 cohorts may reveal differences between the population in a peripheral
teaching hospital versus the patient population of the university hospital.

Treating physicians in arm A will receive the information of the PCR
diagnostics within 48 hours

Several minutes of time will be asked at parents for gaining extra information
of the clinical history of their child.
There are no risks.