Atypical Testing in the Viral Era

Study questions routine testing for atypical bacterial co-infection in viral respiratory hospitalizations

By
Conexiant News Staff
February 2, 2026
3 min

Conexiant

Objective:

To evaluate the value of routine testing and empirical treatment for atypical bacterial co-infections in patients hospitalized with viral respiratory infections.

Approach:

Key Findings:

Confirmed co-infection with atypical bacteria was rare, with only 21 positive results among nearly 20,000 patients.
Testing for atypical bacteria was performed in about 12% of patients, with low positivity rates.
Empirical clarithromycin was administered to 4% of patients, often without prior positive test results.

Interpretation:

Routine diagnostic testing and empirical macrolide therapy for atypical bacterial co-infections in viral respiratory infections may not be justified, except in specific cases.

Limitations:

Low prevalence of confirmed atypical bacterial co-infection limits further characterization of clinical features.
Testing frequency varied by hospital, which may affect generalizability.

Conclusion:

The study findings do not support routine testing or treatment for atypical pneumonia in patients with viral respiratory infections, with exceptions for severely ill patients or those with specific risk factors.