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

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 microL (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 7.4x10(9)/L and 8.1x10( 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 7.2x10(9)/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.