CONTINUING EDUCATION :: RESPIRATORY INFECTIONS AND ANTIMICROBIAL STEWARDSHIP
Respiratory illnesses: A growing opportunity for stewardship
By Anooj Shah, PharmD, MBA, BCIDP; Marti Juanola Falgarona, PhD O in human beings,1
nly the rare individual hasn’t been sickened by a respira- tory infection — either viral or bacterial. After all, these pathogens are among the most common causes of disease and a leading cause of death.2
Properly di-
agnosing respiratory pathogens can be extremely difficult to do in the observational physician office setting, primarily because
Earning CEUs
See test on page 12 or online at
www.mlo-online.com under the CE Tests tab. Passing scores of 70 percent or higher are eligible for 1 contact hour of P.A.C.E. credit.
LEARNING OBJECTIVES Upon completion of this article, the reader will be able to:
1. Discuss the challenges that the healthcare industry faces with respiratory illness diagnosis.
2. Define syndromic testing and describe its benefits. 3. Describe the benefits of multiplex PCR testing and its utility in diagnosing respiratory illnesses.
4. Describe how diagnostic and antimicrobial stewardship work to improve antimicrobial resistance.
6 | SEPTEMBER 2023
MLO-ONLINE.COM
the symptoms of influenza, respiratory syncytial virus (RSV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and other respiratory infections are often indistinguishable.3 Further complicating matters, the pandemic emergency caused shifting of assumed seasonal patterns, which have served as a “guide” for physicians’ observational diagnoses. Pandemic emergency measures such as social distancing and masking disrupted typical seasonal patterns of respiratory infections, including muting influenza for two years. When these measures ended and borders reopened, viral pathogens began to circulate again, but not on their usual schedule. A study of the 2022 flu season in Australia found that the incidence of flu peaked fully two months earlier than it had for the entire decade prior — in mid-June versus mid-August. Given that Australians typically receive their seasonal flu vaccine between March and May, the early start to the flu season meant that a smaller proportion of the population had received their annual flu shot.4
The overlap of respiratory
symptoms, along with the blurring of seasonal lines, reinforces the need for labs, and the doctors and public health officials who rely on them, to think in terms of syndromic diagnostics to help effectively manage patient and population health and monitor viral co-circulation.5
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