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Impact of a multiplex respiratory PCR panel on antibiotic stewardship in hospitalized pediatric pneumonia: a

Jiande Chen1, Jing Wang2, Yuanjie Zhou2

  • 1Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

European Journal of Pediatrics
|June 13, 2026
PubMed

Insights

The FILMARRAY® Pneumonia Panel (FAPP) did not significantly alter initial antibiotic prescriptions in pediatric pneumonia patients. However, FAPP improved targeted antimicrobial adjustments and antibiotic de-escalation, showing potential value for antibiotic stewardship.

Area of Science:

  • Clinical microbiology
  • Infectious diseases
  • Pediatric medicine

Background:

  • Molecular diagnostic panels like FILMARRAY® (FAPP) show promise in guiding antimicrobial therapy for lower respiratory tract infections in adults.
  • Previous research suggests FAPP can aid in reducing antibiotic use and enabling targeted treatment.

Purpose of the Study:

  • To evaluate if the FILMARRAY® Pneumonia Panel (FAPP), in addition to standard care, could effectively guide antibiotic prescriptions in hospitalized pediatric patients with infectious pneumonia.
  • To assess the impact of FAPP on antibiotic modification rates, targeted antimicrobial adjustments, and antibiotic de-escalation within 72 hours.

Main Methods:

  • A single-center, open-label, randomized controlled trial enrolled 315 pediatric patients (28 days to 18 years) diagnosed with infectious pneumonia.
  • Participants were randomized to standard care or standard care plus FAPP.
  • The primary outcome was the proportion of patients with an antibiotic change within 72 hours; secondary outcomes included changes in antibiotic/antiviral agents and antibiotic de-escalation.

Main Results:

  • No significant difference was observed in the primary outcome (antibiotic change within 72 hours) between the FAPP group (51.6%) and the control group (49.4%).
  • Exploratory secondary outcomes showed significant improvements in the FAPP group: higher frequency of targeted antimicrobial agent changes (47.8% vs. 25.3%) and a greater proportion of patients with antibiotic de-escalation (14.6% vs. 1.9%).
  • FAPP detected pathogens in 86.6% of cases, though enhanced sensitivity may identify colonizing organisms.

Conclusions:

  • Integrating FAPP into pediatric pneumonia management did not significantly increase overall initial antibiotic modification rates.
  • FAPP demonstrated value by improving targeted antimicrobial adjustments and facilitating antibiotic de-escalation, supporting its role in antibiotic stewardship programs.
  • Further trials are recommended to confirm the clinical utility and impact of FAPP in pediatric pneumonia management.

Keywords:
Antibiotic prescriptionFILMARRAY® Pneumonia PanelInfectious pneumoniaPediatric

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