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Application of Real-Time PCR Syndromic Panel on Lower Respiratory Tract Samples: Potential Use for Antimicrobial
Christian Leli1, Paolo Bottino1, Lidia Ferrara1
1Microbiology and Virology Laboratory, University Hospital "SS Antonio e Biagio e C. Arrigo", Via Venezia 16, 15121 Alessandria, Italy.
Microorganisms
|July 30, 2025
Summary
Molecular testing aids in pneumonia diagnosis and guides antimicrobial de-escalation. This approach helps avoid unnecessary antibiotic use in 35% of patients, combating antimicrobial resistance.
Area of Science:
- Clinical microbiology
- Infectious diseases
- Pharmacology
Background:
- Antimicrobial resistance is a growing threat, driven by prolonged antibiotic use without confirmed infections.
- Rapid molecular diagnostics offer potential for targeted therapy and antimicrobial stewardship.
Purpose of the Study:
- To evaluate the utility of molecular testing in guiding antimicrobial de-escalation for suspected pneumonia.
- To assess the impact of molecular test results on antibiotic therapy modification.
Main Methods:
- Real-Time Polymerase Chain Reaction (PCR) was used for direct processing of respiratory samples.
- Clinical data from 174 patients with suspected pneumonia were analyzed retrospectively.
- Antimicrobial therapy modifications, including de-escalation, were recorded post-molecular testing.
Main Results:
- Molecular test results led to antimicrobial therapy modification in 47.1% of patients.
- Antimicrobial de-escalation was performed in 34.1% of those with modified therapy.
- Unnecessary antimicrobials were avoided or discontinued in 35% of all patients.
Conclusions:
- Molecular diagnostic panels can assist clinicians in making informed decisions about empiric antibiotic de-escalation.
- Utilizing rapid molecular identification of pathogens and resistance genes supports antimicrobial stewardship efforts.
- This approach contributes to reducing inappropriate antibiotic exposure in pneumonia management.
