2002. BioFire® Filmarray® Pneumonia Panel: A Powerful Rapid Diagnostic Test for Antimicrobial Stewardship

BACKGROUND: BioFire® Filmarray® Pneumonia Panel (BFPP) is a multiplex PCR panel that identifies 33 common bacterial and viral pathogens seen in community- and hospital-acquired pneumonias. It rapidly identifies these pathogens in addition to 7 antibiotic resistance genes on sputum and bronchioalveolar lavage samples in 1 hour. As one of the test centers for this panel, our institution utilized this panel for clinical and laboratory use. We reviewed the impact of BFPP on antimicrobial stewardship, particularly its role in early discontinuation of empiric antibiotics and prompt initiation of optimized targeted therapy. METHODS: We retrospectively reviewed all cases by which BFPP was ordered. We reviewed medical records of each case to identify the results of the panel, culture data, antibiotics used, and subsequent clinical intervention. RESULTS: 43 tests were ordered in total. 17 were for clinical use by an infectious disease specialist and 26 were randomly obtained by the microbiology lab. All 17 clinical cases were intervened upon with the following interventions: discontinuation of anti-pseudomonal antibiotics (8 cases), discontinuation of anti-MRSA antibiotics (5 cases), discontinuation of azithromycin (4 cases), discontinuation of carbapenem (1 case), prevention of inappropriate antibiotic escalation or initiation of inappropriate antibiotics (2 cases), and early IV to PO transition (3 cases). Of the random 26 samples ordered by lab, 13 had opportunities for antibiotic de-escalation if a physician were notified of the results. Viruses were identified in 15 samples with coronavirus being the most common. Virus was the sole pathogen in 9 of the 15 samples. Bacterial pathogens were identified in 20 samples that were reported as normal flora by conventional culture; none of these cases led to or potentially could have led to antibiotic escalation as the sole intervention. CONCLUSION: Clinical use of BFPP had 100% intervention rate with all interventions leading to de-escalation of antibiotics or prevention of inappropriate antibiotics use. Though over-identification of colonizers is a potential limitation, BFPP is a powerful tool for antibiotic stewardship that results in rapid interventions to achieve optimal targeted therapy. DISCLOSURES: All authors: No reported disclosures.