A multiplex polymerase chain reaction assay for antibiotic stewardship in suspected pneumonia.

BACKGROUND: Multiplexed molecular rapid diagnostic tests (RDTs) may allow for rapid and accurate diagnosis of the microbial etiology of pneumonia. However, little data are available on multiplexed RDTs in pneumonia and their impact on clinical practice. METHODS: This retrospective study analyzed 659 hospitalized patients for microbiological diagnosis of suspected pneumonia. RESULTS: The overall sensitivity of the Unyvero LRT Panel was 85.7% (95% CI 82.3-88.7) and the overall specificity was 98.4% (95% CI 98.2-98.7) with a negative predictive value of 97.9% (95% CI 97.6-98.1). The LRT Panel result predicted no change in antibiotics in 12.4% of cases but antibiotic de-escalation in 65.9% (405/615) of patients, of whom 278/405 (69%) had unnecessary MRSA coverage and 259/405 (64%) had unnecessary P. aeruginosa coverage. INTERPRETATION: In hospitalized adults with suspected pneumonia, use of an RDT on respiratory samples can allow for early adjustment of initial antibiotics, most commonly de-escalation.