IntroductionAcute respiratory infections (ARI) are a common cause of inappropriate antibiotic prescription (ATB) in pediatrics. FebriDx® is a rapid diagnostic test that differentiates between viral and bacterial infections. The objective is to analyse the impact of FebriDx® on ATB prescription when managing febrile ARI. MethodsProspective study carried out in patients aged 1–<18 years with febrile ARI in the emergency department. FebriDx® was performed and the impact on management was evaluated at follow-up. ResultsA total of 216 patients were included. Clinical assessment and FebriDx® result coincided coincided in 174 (80.5%) cases. A modification of the initial therapeutic plan was made in 22 (52.4%) of the 42 discordant ones (10.2% of the overall patients). In pneumonia the impact was 34.5%; in all cases it involved not prescribing ATB. ConclusionsFebriDx® could be a useful tool in the management of pediatric patients with febrile ARI to optimize ATB prescription.