Clinical impact of the BIOFIRE FILMARRAY Pneumonia Panel combined with antimicrobial stewardship education on pediatric patients with lower respiratory tract infection: a pre–post study from a tertiary center in Nara, Japan

@article{kitagawa2026clinical,
  title = {{Clinical impact of the BIOFIRE FILMARRAY Pneumonia Panel combined with antimicrobial stewardship education on pediatric patients with lower respiratory tract infection: a pre–post study from a tertiary center in Nara, Japan}},
  author = {Daisuke Kitagawa and Antonio Di Lorenzo and Takumi Okamura and Soshi Hachisuka and Naohiro Yamamoto and Hiroki Nishikawa and Masayuki Onaka and Rika Suzuki and Soma Suzuki and Fumihiko Nakamura and Sayaka Yoshida and Taito Kitano},
  journal = {Microbiology Spectrum},
  year = {2026},
  month = sep,
  doi = {10.1128/spectrum.02213-26},
  url = {https://doi.org/10.1128/spectrum.02213-26},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Clinical impact of the BIOFIRE FILMARRAY Pneumonia Panel combined with antimicrobial stewardship education on pediatric patients with lower respiratory tract infection: a pre–post study from a tertiary center in Nara, Japan
AU  - Daisuke Kitagawa
AU  - Antonio Di Lorenzo
AU  - Takumi Okamura
AU  - Soshi Hachisuka
AU  - Naohiro Yamamoto
AU  - Hiroki Nishikawa
AU  - Masayuki Onaka
AU  - Rika Suzuki
AU  - Soma Suzuki
AU  - Fumihiko Nakamura
AU  - Sayaka Yoshida
AU  - Taito Kitano
PY  - 2026
DA  - 2026/09/22
JO  - Microbiology Spectrum
DO  - 10.1128/spectrum.02213-26
UR  - https://doi.org/10.1128/spectrum.02213-26
AB  - Lower respiratory tract infections (LRTIs) account for a large share of pediatric antimicrobial prescriptions. The BIOFIRE FILMARRAY Pneumonia Panel (FAPN; BioMérieux) detects 33 respiratory pathogens within approximately 1 h. We investigated the clinical impact of its systematic introduction—combined with antimicrobial stewardship education. A retrospective cohort study was conducted at a tertiary pediatric center in Japan, enrolling all children aged <18 years with a lower respiratory tract infection between April 2023 and April 2026. In the post-FAPN period (April 2025–April 2026), the FAPN was implemented, alongside structured stewardship education incorporating a clinical decision flowchart. Logistic regression and generalized linear model (GLM) regression with log-link negative binomial distribution were employed for categorical and quantitative outcomes, respectively. Interrupted time-series analysis (ITSA) was performed using bimesters as time units and Newey-West standard errors. A total of 815 children were enrolled (pre-FAPN: 590; post-FAPN: 225). Antimicrobial prescribing rates were significantly lower following FAPN implementation (adjusted odds ratio, aOR: 0.39; 95% CI: 0.28–0.55; P < 0.001). Adjusted GLM regression identified a significant reduction in broad-spectrum antibiotic DOTs (adjusted β: −0.41; 95% CI: −0.66 to −0.05; P = 0.001), while narrow-spectrum antibiotic DOTs were unchanged. ITSA also confirmed a significant reduction in antimicrobial prescription rate (β: −0.53; 95% CI: −0.84 to −0.21; P = 0.001). The FAPN, combined with structured stewardship education, was significantly associated with reduced antimicrobial prescribing and a shift away from broader-spectrum antimicrobials. These findings support the clinical value of rapid multiplex PCR diagnostics in pediatric LRTIs when integrated with a strong antimicrobial stewardship program.  IMPORTANCE: A strong stewardship education program may need to be combined with the introduction of a multiplex PCR test for pediatric pneumonia. With a clear decision flowchart, clinicians could successfully reduce antimicrobial use and shift their antimicrobial prescriptions to narrower ones.
SN  - 2165-0497
ER  -