SynthesisCritical care (London, England)2025
Impact of syndromic molecular diagnostics on antimicrobial adequacy and time to therapy in critically ill patients with pneumonia: a systematic review and meta-analysis of randomized trials.
Synthesis in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed.
- Clinical Impact of the BIOFIRE® FILMARRAY® Pneumonia Panel in the Veterans Affairs Healthcare System: A Difference-in-Differences Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Observational
- Cumulative respiratory pathogen detection burden by multiplex PCR is associated with mortality in a TB-enriched ICU cohort.Microbiology spectrum · 2026Article
- Impact of a strategy using multiplex PCR on targeted antibiotic therapy for patients with suspected ventilator-associated pneumonia or hospital-acquired pneumonia requiring mechanical ventilation: a randomized, single-blind trial.Intensive care medicine · 2026Article
- Scenario-Driven Rapid Testing for Top Pathogens in Pediatric Respiratory Infections: Clinical and Economic Value from Emergency Triage to Precision Anti-Infective Management in the PICU.Pathogens (Basel, Switzerland) · 2026Review
- Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- The Role of Combination Antibiotic Therapy in Combatting Drug-ResistantAntibiotics (Basel, Switzerland) · 2026Review
- Integrating Syndromic Molecular Assays into Routine Diagnostic Microbiology: Benefits and Challenges.Antibiotics (Basel, Switzerland) · 2026Article
- Severe community-acquired pneumonia: an integral approach.Journal of intensive care · 2026Review
- The SIS NET ICU study: characteristics of patients with severe community acquired pneumonia admitted to Italian ICUs-a multicenter prospective observational study.Journal of anesthesia, analgesia and critical care · 2026Article
- Article
- Etiologic diagnosis of hospitalized patients with community-acquired pneumonia: bridging the evidence gap.Respiratory research & clinical practice · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPneumonia is a leading cause of ICU admission and mortality, requiring prompt and adequate antimicrobial therapy to improve outcomes. Conventional cultures are slow and often insensitive, delaying targeted treatment. Syndromic PCR panels offer rapid identification of pathogens and resistance genes directly from respiratory samples, potentially improving early antibiotic optimization. However, the true clinical benefit of these diagnostics in critically ill patients remains uncertain.
methodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing PCR-based molecular diagnostics with standard culture techniques in predominantly adult ICU patients with severe community-acquired, hospital-acquired, or ventilator-associated pneumonia. Literature searches were performed in PubMed, Embase, and Cochrane CENTRAL from inception to July 16, 2025. The primary outcome was in-hospital mortality. Secondary outcomes included adequacy of initial antimicrobial therapy and time to effective antibiotic administration. Data were synthesized using random-effects models.
resultsWe included five randomized controlled trials comprising 2,466 patients. Syndromic PCR testing did not significantly reduce in-hospital mortality, the primary outcome (RR 1.04; 95% CI: 0.90–1.21; p = 0.57; I² = 0%). However, PCR testing was associated with a higher rate of adequate initial antimicrobial therapy (RR 1.82; 95% CI: 1.10–3.00; p = 0.02; I² = 97%) and a reduction in time to effective antibiotic administration (mean difference − 27.98 h; 95% CI: − 46.07 to − 9.89; p = 0.002; I² = 94%).
conclusionsSyndromic PCR diagnostics did not reduce in-hospital mortality in critically ill patients with pneumonia but were associated with improved adequacy of initial antimicrobial therapy and faster initiation of effective treatment. These findings support their role as a complementary tool in ICU-based antimicrobial stewardship.
trial registrationPROSPERO CRD420251006301.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.