The impact of fast microbiology assays on clinical stewardship: a retrospective study

Acute respiratory infections (ARIs) are among the most common infections, with variable etiology, affecting both community and hospital settings. Vulnerable populations include children, the elderly, and patients with chronic debilitating disease. Early identification of the causative pathogen can reduce inappropriate empirical antibiotic therapy, particularly in viral infection cases, which are the leading cause of ARIs, especially in outpatient settings. Rapid molecular diagnostic methods such as FilmArray Respiratory Panel (FA RP) enable the prompt identification of viral and bacterial pathogens. A retrospective observational study was conducted at Santa Maria Goretti Hospital in Latina, Italy, from January 1, 2022, to April 30, 2023. A total of 232 nasopharyngeal swabs from patients were analyzed using the BioFire FA RP. Eligible patients exhibited fever, cough, or other symptoms suggestive of respiratory infection. The test distribution shows that the Pediatric and Neonatology Units had the highest number of tests and a high proportion of clinically relevant outcomes. The findings underscore the effectiveness of the FA RP in swiftly identifying pathogens, significantly reducing diagnostic turnaround times, and minimizing unnecessary antibiotic prescriptions. The 38% rate of negative tests highlights the importance of appropriate test prescription based on clinical assessment.