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Clinical and cost implications of Biofire FilmArray® meningitis / encephalitis panel testing: a systematic review

Nastaran Rafiei1, Shradha Subedi2, Patrick Na Harris3

  • 1Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Australia; Caboolture Hospital, Queensland, Australia.

Diagnostic Microbiology and Infectious Disease
|March 30, 2025
PubMed
Abstract

Insights

The Biofire FilmArray® Meningitis/Encephalitis Panel (MEP) reduces acyclovir use for infectious meningoencephalitis. However, its impact on antibiotic use and hospital stay varies by institution and patient population.

Area of Science:

  • Clinical microbiology
  • Infectious diseases
  • Diagnostic technology

Background:

  • Meningitis and encephalitis have high mortality and sequelae rates, often lacking etiological diagnosis due to conventional testing limitations.
  • The Biofire FilmArray® Meningitis/Encephalitis Panel (MEP) is a multiplex PCR diagnostic tool for infectious meningoencephalitis, offering rapid results.
  • MEP has the potential to decrease empiric antimicrobial use and shorten hospital stays compared to traditional methods.

Purpose of the Study:

  • To systematically review the impact of implementing the MEP on patient outcomes.
  • To evaluate changes in acyclovir treatment duration, antimicrobial use, length of hospital stay, and healthcare costs post-MEP implementation.

Main Methods:

  • Systematic review of Medline and Embase databases.
  • Inclusion of 23 studies, primarily retrospective, comparing pre- and post-MEP implementation cohorts.
  • Outcomes assessed included duration of acyclovir and antimicrobial treatment, length of stay, and healthcare costs.

Main Results:

  • MEP implementation reduced acyclovir use in 75% of studies (average 39 hours).
  • Reductions in antimicrobial use and length of stay were observed in 44% and 40% of studies, respectively.
  • Healthcare cost analysis was variable; one study showed reduced total hospitalization costs, while two showed no change.

Conclusions:

  • MEP implementation effectively reduces acyclovir usage in patients evaluated for meningitis/encephalitis.
  • The benefits of MEP on antibiotic use and length of stay are inconsistent.
  • Variability in outcomes likely depends on patient population, implementation strategy, and available standard diagnostic tests.
Keywords:
EncephalitisFilmArrayMeningitisMultiplex PCRSystematic review

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