Reply

Abstract

Meyer et al raise a number of interesting points regarding the use of multiplex polymerase chain reaction (mPCR) testing in patients with febrile seizures. In their letter, the authors report findings from their study on the use of antibiotics in patients with febrile seizures before and after the initiation of mPCR testing. In their analysis of 200 children with febrile seizures, they note an increase in rates of positive viral tests after initiation of mPCR, as well as an increase in patients with positive bacterial/fungal testing, which possibly could have contributed to the increase in children treated with antibiotics. Although we look forward to reviewing the complete data in a peer-reviewed manuscript, we recognize that they do highlight the need to understand the use and interpretation of mPCR results in specific populations. In summary, we agree that although viral respiratory testing may contribute to diagnosis, it should be used in conjunction with other factors, including clinical presentation, physical examination, epidemiologic data, and other testing to determine the etiology of acute respiratory illnesses. Meyer et al highlight the need for future studies in this area among specific populations, such as patients with febrile seizures. Multiplex polymerase chain reaction testing in pediatric inpatients with febrile seizuresThe Journal of PediatricsVol. 179PreviewIn their large retrospective study, Subramony et al1 compared the use of antibiotics, chest radiographs, and isolation precautions for patients <18 years old, hospitalized at a tertiary referral center and tested for respiratory pathogens in the emergency department or during the first 2 hospital days during a non-multiplex polymerase chain reaction period (non-mPCR; 2349 patients) vs a multiplex polymerase chain reaction period (mPCR; 2430 patients). The authors demonstrated that patients in the mPCR group had more positive tests (42.4% vs 14.4%, P < .01), had received fewer days of antibiotics (4 vs 5 median antibiotic days, P < .01), had fewer chest radiographs performed, (59% vs 78%, P < .01), and were placed in isolation longer (20 vs 0 median isolation-hours, P < .01) compared with the non-mPCR group. Full-Text PDF