Real-World Evaluation of a Pneumonia PCR Panel: Appropriateness, Outcomes, and Antimicrobial Stewardship Implications.

Abstract

Purpose: Pneumonia polymerase chain reaction panels are diagnostic tools that allow rapid identification of respiratory pathogens and bacterial resistance genes. These panels are frequently used as an antimicrobial stewardship tool to optimize antimicrobial therapy for patients with suspected pneumonia. The purpose of this study is to evaluate the appropriate utilization of pneumonia panels and how their results influence clinicians to make changes to antibiotic regimens for patients with suspected pneumonia.

Methods: This was a retrospective cohort study conducted within a single academic medical center. Adult patients with pneumonia panel results reported between February 1, 2024, and October 1, 2024, were included in the study. The primary outcome was the percentage of pneumonia panels inappropriately ordered. Secondary endpoints were the percentage of patients with pneumonia panels inappropriately ordered, the percentage of patients receiving appropriate antibiotics, patients with antibiotics appropriately escalated, or deescalated within 24 hours, median hospital and intensive care unit length of stay, in-hospital mortality, and 30-day hospital readmissions.

Results: A total of 712 patients were included for analysis, with 810 total pneumonia panel results reported in the study population. Bacteria were detected on 52.6% of panels, viruses were the only pathogens detected on 12.3% of panels, and no pathogens were detected on 35.1% of panels. Overall, 61.6% of pneumonia panels ordered were inappropriate. Within 24 hours of panel results, appropriate antibiotic escalation occurred in 14.9% of patients, and appropriate antibiotic de-escalation or discontinuation occurred in 19.5% of patients.

Conclusions: In this study, inappropriate ordering of pneumonia panels occurred in more than half of cases. The overall impact on antimicrobial prescribing was limited, with appropriate antibiotic escalation or de-escalation occurring in a small number of patients. These findings highlight the importance of targeted ordering strategies and antimicrobial stewardship interventions to optimize the clinical utility of pneumonia panels.