ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2026
Respiratory multiplex PCR and antimicrobial treatment modification in hospitalized patients with community-acquired pneumonia.
Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Community-acquired pneumonia (CAP) is a major cause of hospitalization, and pathogen identification is often limited by low diagnostic yield of conventional microbiological methods. Respiratory multiplex PCR (mPCR) enables rapid pathogen detection, but its role in antimicrobial treatment modification for inpatients with CAP remains unclear. This study evaluated the association between mPCR testing and antimicrobial modification in hospitalized patients with CAP. Methods: This retrospective, single center cohort study included hospitalized patients with CAP identified using ICD-10 codes between July 2023 and February 2025. Respiratory mPCR was performed within the first 24 hours of admission using combined nasopharyngeal/oropharyngeal (NP/OP) swabs. The primary outcome was antimicrobial treatment modification guided by mPCR results and documented by physicians. Secondary outcomes included antimicrobial de-escalation and hospital length of stay. Results: In this cohort of 145 patients, mPCR detected a pathogen in 56 patients (38.6%): viral pathogens in 30 (20.7%) and bacterial pathogens in 26 (17.9%). Overall antimicrobial treatment was modified in 54 patients (37.2%). Modification guided by mPCR results and documented by physicians occurred in 37 patients (25.5%). Among these 37 modifications, 35 (94.6%) were classified as antimicrobial de-escalation. Hospital length of stay did not differ significantly across mPCR results. Conclusions: In hospitalized patients with CAP, mPCR facilitates targeted antimicrobial treatment modification and drives high rates of de-escalation. These findings demonstrate the significant utility of mPCR in optimizing clinical decisions and enhancing antimicrobial stewardship.
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