***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Managing children with influenza-like illness is associated with costly and painful interventions because , in order to distinguish viral from bacterial infections , diagnostic tests ( including routine blood examinations and chest radiographs ) are frequently performed,1,2 and the empirical use of antimicrobial agents is common.3 Various rapid diagnostic techniques for the detection of influenza viruses have been developed , but few data are available on their impact on child care.2,4,5 The aim of this study was to assess the effect of a rapid diagnosis of influenza infection on the management of children with influenza-like illness in an emergency department . All patients seen for influenza-like illness from 6 January to 27 February 2002 , at the paediatric emergency department of the University of Milan , Italy , were enrolled and blindly r and omly assigned in a 1:1 ratio to undergo a rapid test for the detection of influenza viruses or no rapid test . Influenza-like illness was defined as an axillary temperature of ⩾37.8 ° C and at least one symptom of acute upper or lower respiratory tract disease.6 The patients who underwent the test had their throats swabbed after vigorously rubbing both tonsillar surfaces and the posterior pharynx ; the swab was then immediately su bmi tted to the Quickvue influenza test ( Quidel , Milan , Italy ) for the rapid detection of influenza A and B viruses . The test , which has an overall sensitivity of 74–95 % and an overall specificity of 76–98%,5,7,8 was performed by a postgraduate student in accordance with the manufacturer ’s recommendations . The results were available after 10 OBJECTIVE To determine the impact of the rapid diagnosis of influenza on physician decision-making and patient management , including laboratory tests and radiographs ordered , patient charges associated with these tests , antibiotics/antivirals prescribed , and length of time to patient discharge from the emergency department . METHODS Patients aged 2 months to 21 years presenting to an urban children 's teaching hospital emergency department were screened for fever and cough , coryza , myalgias , headache , and /or malaise . After obtaining informed consent , patients were r and omized to 1 of 2 groups : 1 ) physician receives ( physician aware of ) the rapid influenza test result ; or 2 ) physician does not receive ( physician unaware of ) the result . For patients in the physician aware group , nasopharyngeal swabs were obtained , immediately tested with the FluOIA test for influenza A and B , and the result was placed on the chart before patient evaluation by the attending physician . For the physician unaware group , nasopharyngeal swabs were obtained , stored according to manufacturer 's directions , and tested within 24 hours . Results for the physician unaware group were not disclosed to the treating physicians at any time . The 2 result ant influenza-positive groups ( aware and unaware ) were compared for laboratory and radiograph studies and their associated patient charges , antibiotic/antiviral prescriptions , and length of stay in the emergency department . RESULTS A total of 418 patients were enrolled , and 391 completed the study . Of these , 202 tested positive for influenza . Comparison of the 96 influenza-positive patients whose physician was aware of the result with the 106 influenza-positive patients whose physician was unaware of the result revealed significant reductions among the former group in : 1 ) numbers of complete blood counts , blood cultures , urinalyses , urine cultures , and chest radiographs performed ; 2 ) charges associated with these tests ; 3 ) antibiotics prescribed ; and 4 ) length of stay in the emergency department . The number of influenza-positive patients who received prescriptions for antiviral drugs  was significantly higher among those whose physician was aware of the result . CONCLUSIONS Physician awareness of a rapid diagnosis of influenza in the pediatric emergency department significantly reduced the number of laboratory tests and radiographs ordered and their associated charges , decreased antibiotic use , increased antiviral use , and decreased length of time to discharge Summary Background Respiratory virus infection is a common cause of hospitalisation in adults . Rapid point-of-care testing ( POCT ) for respiratory viruses might improve clinical care by reducing unnecessary antibiotic use , shortening length of hospital stay , improving influenza detection and treatment , and rationalising isolation facility use ; however , insufficient evidence exists to support its use over st and ard clinical care . We aim ed to assess the effect of routine POCT on a broad range of clinical outcomes including antibiotic use . Methods In this pragmatic , parallel-group , open-label , r and omised controlled trial , we enrolled adults ( aged ≥18 years ) within 24 h of presenting to the emergency department or acute medical unit of a large UK hospital with acute respiratory illness or fever higher than 37·5 ° C ( ≤7 days duration ) , or both , over two winter seasons . Patients were r and omly assigned ( 1:1 ) , via an internet-based allocation sequence with r and om permuted blocks , to have a molecular POC test for respiratory viruses or routine clinical care . The primary outcome was the proportion of patients who received antibiotics while hospitalised ( up to 30 days ) . Secondary outcomes included duration of antibiotics , proportion of patients receiving single doses or brief courses of antibiotics , length of stay , antiviral use , isolation facility use , and safety . Analysis was by modified intention to treat , excluding patients who declined intervention or were withdrawn for protocol violations . This study is registered with IS RCT N , number 90211642 , and has been completed . Findings Between Jan 15 , 2015 , and April 30 , 2015 , and between Oct 1 , 2015 , and April 30 , 2016 , we enrolled 720 patients ( 362 assigned to POCT and 358 to routine care ) . Six patients withdrew or had protocol violations . 301 ( 84 % ) of 360 patients in the POCT group received antibiotics compared with 294 ( 83 % ) of 354 controls ( difference 0·6 % , 95 % CI −4·9 to 6·0 ; p=0·84 ) . Mean duration of antibiotics did not differ between groups ( 7·2 days [ SD 5·1 ] in the POCT group vs 7·7 days [ 4·9 ] in the control group ; difference −0·4 , 95 % CI −1·2 to 0·4 ; p=0·32 ) . 50 ( 17 % ) of 301 patients treated with antibiotics in the POCT group received single doses or brief courses of antibiotics ( < 48 h ) compared with 26 ( 9 % ) of 294 patients in the control group ( difference 7·8 % , 95 % CI 2·5 to 13·1 ; p=0·0047 ; number needed to test=13 ) . Mean length of stay was shorter in the POCT group ( 5·7 days [ SD 6·3 ] ) than in the control group ( 6·8 days [ 7·7 ] ; difference −1·1 , 95 % CI −2·2 to −0·3 ; p=0·0443 ) . Appropriate antiviral treatment of influenza-positive patients was more common in the POCT group ( 52 [ 91 % ] of 57 patients ) than in the control group ( 24 [ 65 % ] of 37 patients ; difference 26·4 % , 95 % CI 9·6 to 43·2 ; p=0·0026 ; number needed to test=4 ) . We found no differences in adverse outcomes between the groups ( 77 [ 21 % ] of 360 patients in the POCT group vs 88 [ 25 % ] of 354 patients in the control group ; −3·5 % , −9·7 to 2·7 ; p=0·29 ) . Interpretation Routine use of molecular POCT for respiratory viruses did not reduce the proportion of patients treated with antibiotics . However , the primary outcome measure failed to capture differences in antibiotic use because many patients were started on antibiotics before the results of POCT could be made available . Although POCT was not associated with a reduction in the duration of antibiotics overall , more patients in the POCT group received single doses or brief courses of antibiotics than did patients in the control group . POCT was also associated with a reduced length of stay and improved influenza detection and antiviral use , and appeared to be safe . Funding University of Southampton OBJECTIVE To present our experience regarding the use of a rapid diagnostic test for seasonal influenza A and B. METHODS We systematic ally collected and analyzed our data regarding the use of a rapid diagnostic test for seasonal influenza A and B in patients with specific respiratory symptoms that sought medical services , during the time period from 01/01/2009 to 30/05/2009 , from a network of physicians ( SOS Doctors ) who perform house-call visits in the area of Attica , Greece . RESULTS From the total of 16,335 house-call visits performed during the evaluated period , 3412 ( 20.8 % ) were due to respiratory/influenza symptoms ; 197 ( 5.8 % ) patients were tested for influenza . From the 184 patients with available data regarding the test result , 97 ( 52.7 % ) were positive for influenza . Significantly more  oseltamivir and less antibiotic treatment were prescribed to patients with positive test result compared with those with a negative test result . Additionally , the impact of the test in the participating physicians ' decision making was obvious , as doctors who used the test systematic ally prescribed significantly more oseltamivir and less antibiotic treatment compared to the doctors who did n't use the test . CONCLUSION The use of a rapid test for seasonal influenza enabled the targeted treatment with oseltamivir , as well as a reduction in antibiotic treatment , in patients found positive for influenza in our clinical setting BACKGROUND Influenza affects many people worldwide each year and has many troublesome symptoms . We investigated the efficacy and safety of the inhaled antiviral agent zanamivir as a treatment for influenza A and B infection . METHODS In a r and omised , double-blind , placebo-controlled trial , we recruited 455 patients aged 12 years and older with influenza-like symptoms of 36 h duration or less who lived in Australia , New Zeal and , and South Africa . Eligible patients were r and omly assigned 10 mg inhaled zanamivir ( n=227 ) or placebo ( n=228 ) twice daily for 5 days . All patients recorded symptoms on diary cards four times daily during treatment and twice daily for 9 days after treatment . We analysed all patients by intention to treat , influenza-positivity , and high risk of developing complications . FINDINGS Compared with placebo , zanamavir relieved influenza symptoms a median of 1.5 days earlier in the intention-to-treat ( p=0.011 ) and influenza-positive ( p=0.004 ) population s , and 2 days earlier in patients who were febrile at entry [ corrected ] . In high-risk patients treated with zanamivir , symptoms were alleviated a median of 2.5 days earlier ( p=0.048 ) , fewer had complications ( p=0.004 ) , and fewer used complication-associated antibiotics ( p=0.025 ) compared with placebo . The adverse event profiles were similar for zanamivir and placebo . INTERPRETATION Zanamivir was well-tolerated and effective in decreasing the duration and severity of symptoms . Complications were also decreased in high-risk patients but these findings need to be confirmed in future studies due to the limited number of patients [ corrected ] OBJECTIVES Acute respiratory tract infections represent a significant burden on pediatric emergency departments ( ED ) and families . We hypothesized that early and rapid diagnosis of a viral infection alleviates the need for ancillary testing and antibiotic treatment . STUDY DESIGN We conducted a r and omized , controlled trial of children 3 to 36 months of age with febrile acute respiratory tract infections at a pediatric ED . Two hundred four subjects were r and omly assigned to receive rapid respiratory viral testing on admission or a routine ED admission protocol . Outcome measures were : mean length of visits , rate of ancillary tests , and antibiotic prescription in the ED . A follow-up call was made to all study subjects to inquire about further healthcare visits , ancillary testing , and antibiotic prescription after ED discharge . RESULTS We did not find a statistically significant difference in ED length of visits , rate of ancillary testing , or antibiotic prescription rate in the ED between the study groups . There was , however , a significant reduction in antibiotic prescription after ED discharge ( in the group who had rapid viral testing RR = 0.36 ; 95 % CI = 0.14 , 0.95 ) . CONCLUSIONS Rapid multi-viral testing in the ED did not significantly affect ED patient treatment but may reduce antibiotic prescription in the community after discharge from the ED , suggesting a novel strategy to alter community physician antibiotic prescription patterns BACKGROUND Fever is a frequent cause of medical consultation among returning travelers . The objectives of this study were to assess whether physicians were able to identify patients with influenza and whether the use of an influenza rapid diagnostic test ( iRDT ) modified the clinical management of such patients . METHODS R and omized controlled trial conducted at 2 different Swiss hospitals between December 2008 and November 2012 . Inclusion criteria were 1 ) age ≥ 18 years , 2 ) documented fever of ≥ 38 ° C or anamnestic fever + cough or s 
    Output:
    
The majority of papers reporting on antiviral prescription found that a positive POCT result significantly increased use of antivirals for influenza compared with negative POCT results and st and ard supportive care .
A positive POCT result also led to decreased antibiotic use .
The studies assessed in this systematic review support the use of POCT for diagnosis of influenza in patients suffering an acute respiratory infection .
Diagnosis using POCT may lead to more appropriate prescription of treatments for infectious agents .