Clinical Utility of Rapid Molecular-Based Influenza Testing

Background. Diagnosing influenza in the emergency department (ED) remains a challenge because clinicians have not had, until recently, reliable tests to accurately and rapidly diagnose influenza; however, rapid diagnosis is crucial to begin antiviral therapy in patients with, or at risk of influenza-related complications, as recommended by the Centers for Disease Control and Prevention (CDC). A new generation of rapid molecular-based tests, including Xpert Flu (Cepheid), have recently demonstrated high sensitivity (95%) and specificity (99%), allowing for timely and accurate influenza diagnosis and improved use of antivirals in the ED. We sought to evaluate the impact of rapid molecular-based influenza testing on clinician decision-making for antiviral administration in ED patients with, or at increased risk for, influenza-related complications.