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. 2025 Apr 2;17(4):e81620.
doi: 10.7759/cureus.81620. eCollection 2025 Apr.

Impact of Respiratory Multiplex Polymerase Chain Reaction (PCR) on Antibiotic Stewardship: A Real-World Experience

Mahuya Bhattacharyya  1 , Subhash Todi  1 , Ananya Saha  2
Affiliations

Impact of Respiratory Multiplex Polymerase Chain Reaction (PCR) on Antibiotic Stewardship: A Real-World Experience

Mahuya Bhattacharyya et al. Cureus. .

Abstract

Background: This study examined whether the use of the multiplex PCR (BioFire-FilmArray [bioMérieux, Marcy-l'Étoile, France]) (BF) technique reduced or optimized antibiotic use in patients admitted to the intensive care unit (ICU) with respiratory sepsis.

Methods: This retrospective observational study included adult patients with pulmonary sepsis admitted to the ICU, where the BF test was performed using lower respiratory samples. The primary outcome measure was any appropriate antibiotic change guided by BF within 24 hours of sending samples. Hospital mortality and length of stay (LOS) were compared between the two groups: the group in which antibiotics were appropriately changed within 24 hours of sending samples for BF and the group in which they were not.

Results: A total of 117 patients with community- and hospital-acquired respiratory sepsis were included in this study. The mean APACHE IV score was 70.5±27.2, and 34 (29.1%) patients were in shock. BF was negative in 31 samples (26.5%), whereas culture was negative in 63 samples (53.8%). BF-guided de-escalation, escalation, and no change in antibiotics were indicated in 62 episodes (53%), 41 episodes (35%), and 14 episodes (11.9%), respectively. However, these changes were achieved in 15 episodes (24.2%), 40 episodes (97.6%), and 14 episodes (100%), respectively (p<0.0001). Hospital mortality and LOS were lower in cases where antibiotic alteration was indicated and performed, compared to cases where it was not (nonsignificant).

Conclusion: The identification of the causative agent using BF was higher. Achieving the appropriateness of antibiotics through escalation or continuation of the same antibiotics was more common than de-escalation. Appropriate early modification of antibiotics was associated with a decreased trend in-hospital mortality and LOS.

Keywords: antibiotic de-escalation; antibiotic optimization; antibiotic stewardship; hospital mortality; multiplex pcr biofire; respiratory sepsis.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. AMRI Hospitals Dhakuria Ethics committee issued approval AMRI-EC/AP-05/MPH/2019-20. After reviewing the study protocol, members of the EC approved study protocol to carry out the work in AMRI Dhakuria It was considered for M Pharm course dissertation. . Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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References

    1. Culture-negative sepsis may be a different entity from culture-positive sepsis: a prospective nationwide multicenter cohort study. Chang Y, Oh JH, Oh DK, et al. Crit Care. 2024;28:385. - PMC - PubMed
    1. Community-acquired pneumonia requiring hospitalization among U.S. adults. Jain S, Self WH, Wunderink RG, et al. N Engl J Med. 2015;373:415–427. - PMC - PubMed
    1. Sputum Gram stain for bacterial pathogen diagnosis in community-acquired pneumonia: A systematic review and Bayesian meta-analysis of diagnostic accuracy and yield. Ogawa H, Kitsios GD, Iwata M, Terasawa T. Clin Infect Dis. 2020;71:499–513. - PMC - PubMed
    1. The rapid diagnosis of viral respiratory tract infections and its impact on antimicrobial stewardship programs. Keske Ş, Ergönül Ö, Tutucu F, et al. Eur J Clin Microbiol Infect Dis. 2018;37:779–783. - PMC - PubMed
    1. Viral detection by reverse transcriptase polymerase chain reaction in upper respiratory tract and metagenomic RNA sequencing in lower respiratory tract in critically ill children with suspected lower respiratory tract infection. Osborne CM, Langelier C, Kamm J, et al. Pediatr Crit Care Med. 2024;25:0. - PMC - PubMed

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