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Updated: May 28, 2026
Experimental Model to Evaluate Resolution of Pneumonia
Published on: February 17, 2023
Evaluating the Impact of Filmarray Pneumonia Plus Panel in Therapeutic Decision-Making in Critical Patients with
Rosa Latorre Ibars1, Sulamita Carvalho-Brugger1,2,3, Paula Rodríguez Ibáñez1
1Department of Intensive Care, Arnau de Vilanova University Hospital, 25198 Lleida, Spain.
Abstract:
Background: Respiratory infections in critically ill patients remain a major challenge in intensive care units (ICUs), with high morbidity and mortality. Conventional microbiological methods often fail to identify the causative pathogen promptly, particularly in patients previously exposed to antibiotics. Multiplex molecular platforms, such as the BioFire FilmArray® Pneumonia Panel Plus (FAPP), allow rapid detection of multiple respiratory pathogens and resistance markers, potentially improving early therapeutic decision-making. The objective of this work is to evaluate the impact of implementing FAPP on antimicrobial therapeutic decisions in critically ill patients with suspected respiratory infection. Methods: We conducted a retrospective cohort study in two mixed ICUs between 2023 and 2024. All respiratory samples in which FAPP was requested were analyzed. The results were compared with conventional cultures, and changes in antimicrobial therapy following the FAPP results were assessed, classified as escalation/initiation or de-escalation/discontinuation. Concordance between FAPP and culture was evaluated, and clinical and demographic variables were analyzed. Differences between groups were assessed using p-values obtained from the chi-square test or the Mann-Whitney test. Results: A total of 363 respiratory samples were included, 88.4% from mechanically ventilated patients. FAPP was positive in 65.3% of samples, whereas cultures were positive in 23.1%. Overall concordance between FAPP and culture was 57.3%. In 42.4% of cases, pathogens were detected exclusively by FAPP. Antimicrobial therapy was modified in 29.8% of patients, predominantly through de-escalation or discontinuation (69.4% of changes). Therapeutic modifications were more frequent in nosocomial infections and in patients with a positive FAPP result. Conclusions: The use of FAPP in critically ill patients with suspected respiratory infection provides rapid microbiological information that significantly influences antimicrobial decision-making, particularly by facilitating antibiotic de-escalation. Although discrepancies with conventional cultures remain and require careful clinical interpretation, FAPP represents a valuable tool for antimicrobial stewardship in the ICU setting.
Insights
The BioFire FilmArray Pneumonia Panel Plus (FAPP) significantly impacts antimicrobial decisions in ICUs by enabling faster pathogen detection and facilitating antibiotic de-escalation in respiratory infections. This molecular platform aids antimicrobial stewardship.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Clinical Microbiology
Background:
- Respiratory infections pose significant challenges in ICUs, leading to high morbidity and mortality.
- Conventional methods for pathogen identification are often slow, especially in antibiotic-exposed patients.
- Multiplex molecular platforms offer rapid detection of pathogens and resistance markers.
Purpose of the Study:
- To evaluate the impact of implementing the BioFire FilmArray Pneumonia Panel Plus (FAPP) on antimicrobial therapy decisions.
- To assess changes in antimicrobial treatment following FAPP implementation in critically ill patients.
- To compare FAPP results with conventional cultures and analyze clinical outcomes.
Main Methods:
- Retrospective cohort study in two mixed ICUs (2023-2024).
- Analysis of respiratory samples using FAPP and conventional cultures.
- Assessment of antimicrobial therapy modifications (escalation/de-escalation) post-FAPP results.
Main Results:
- FAPP detected pathogens in 65.3% of samples, compared to 23.1% for cultures.
- Pathogens were exclusively identified by FAPP in 42.4% of cases.
- Antimicrobial therapy was modified in 29.8% of patients, with 69.4% being de-escalation/discontinuation.
Conclusions:
- FAPP provides rapid microbiological data that significantly influences antimicrobial decision-making in ICUs.
- The panel facilitates antibiotic de-escalation, supporting antimicrobial stewardship.
- Despite discrepancies with cultures, FAPP is a valuable tool for managing respiratory infections in critically ill patients.
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