Film Array Gastrointestinal Panel Compared to Usual Care for ED Evaluation of Infectious Diarrhea

Not Applicable

Terminated

Brief Summary: This research study will test a laboratory test called Film-Array Gastrointestinal (GI) Panel. This GI Panel is a test that can identify the bacteria or viruses that may cause diarrhea. This test will enable the ED doctor to better understand the cause of diarrhea to try to determine the best treatment.

The primary objective of this study is to determine if testing ED patients who complain of diarrhea will lead to more optimal use of antibiotics. Optimal use of antibiotics is defined as the most appropriate antibiotic to treat a specified pathogen.

Recruitment & Eligibility

Inclusion Criteria

Presumed infectious diarrhea (3 or more loose stools in past 24 hours)
Must have one of the 3 following features or symptoms lasting more than 7 days.
1. Symptoms greater than 24 hours;
2. Dehydration (defined as the need for intravenous fluid or per clinician's judgement ((based on the general appearance and alertness of the patient, the pulse, the blood pressure, the presence or absence of postural hypotension, the mucous membranes and tears, sunken eyes, skin turgor, capillary refill, and jugular venous pressure.))
3. Inflammation (defined as fever (greater than 100.1), blood in stool per patient, DRE, or tenesmus.)

Exclusion Criteria

Chronic Symptoms (>14 days)
Inability to Follow- Up (i.e. no telephone)
Prisoner
Likely non-infectious cause of diarrhea (Crohn's disease, radiation colitis, irritable bowel syndrome, or celiac disease)
Confirmed C. Diff Diarrhea
Unable to provide written consent
Non- English speaker

Arm && Interventions

Group	Intervention	Description
Control	Biofire Film Array Gastrointestinal Panel	Gastrointestinal Polymerase Chain Reaction test performed at the conclusion of the study. Clinician will not be informed of results. Usual Care performed per treating physician.
Experimental	Biofire Film Array Gastrointestinal Panel	Gastrointestinal Polymerase Chain Reaction test performed and results communicated to treatment provider. Followed by usual care per treating physician.

Primary Outcome Measures

Name	Time	Method
Number of Participants With Optimal Antibiotic Chosen	30 Days post ED Discharge	Optimal use of antibiotics is defined as the most appropriate antibiotic to treat a specified pathogen. Designated physicians on study staff will retrospectively examine charts of enrolled subjects will evaluate whether the antibiotic chosen by treating clinician was appropriate given GI PCR results.

Secondary Outcome Measures

Name	Time	Method
Hospital Admission Rate	30 Days post ED Discharge
ED Length of Stay	30 Days post ED Discharge	Time from patient arrival to time when patient is officially discharged or admitted
Rate of Abdominal/Pelvic CT Scans	30 Days post ED Discharge