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A Comparison of 2 White Blood Cell Count Devices to Aid Judicious Antibiotic Prescribing

Department of Pediatrics, University of Rochester, Rochester, New York, Legacy Pediatrics, University of Rochester, Rochester, New York

Michael E. Pichichero, MD

Department of Microbiology/Immunology, University of Rochester, Rochester, New York, Michael_pichichero{at}urmc.rochester.edu, Legacy Pediatrics, University of Rochester, Rochester, New York

A low or normal white blood cell (WBC) count is usually associated with viral illnesses. This study evaluated the reliability of a new point-of-care, inexpensive, WBC count device which requires only 10 µL (1 drop) of whole blood from a finger stick to an automated Cell-Dyn® counter in a busy office practice setting and assessed its reliability to assist in avoiding antibiotic prescribing. A total of 120 acutely ill children and potential antibiotic recipients were studied from October 2007 to March 2008. The mean WBC count was 7.4 x 10⁹/L and 8.1 x 10 ⁹/L for the new WBC device and the automated Cell-Dyn counter, respectively. The correlation between the 2 devices was high (r = .988, P = .005). A total of 88 children (73%) did not receive antibiotics and mean WBC was 7.2 x 10⁹/L. In all, 32 children (27%) received an antibiotic and 1 (3%) returned for a follow-up office visit for the same or a related illness. Of the 88 children with a low blood count who did not receive an antibiotic, 3 (3%) had return visit within 30 days and received an antibiotic. A simple and quick point-of-care WBC count device produces similar results as achievable with a Cell-Dyn counter for total WBCs and may assist in judicious antibiotic prescribing.

Key Words: WBC count • judicious use • antibiotic

This version was published on April 1, 2009

Clinical Pediatrics, Vol. 48, No. 3, 291-294 (2009)
DOI: 10.1177/0009922808327106


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