Effect of Using BioFire® FilmArray® in An Antibiotic Stewardship Program: A Meta-analytical Study from a High-Care Hospital in North India
Kanwaljit Kaur
Department of Microbiology, Base Hospital, Delhi Cantt, Delhi, India.
Harpreet Singh
Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
Chandan Kumar Panigrahi
Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
Sakshi Sharma *
Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
Anwesha Dash
Department of Microbiology, AFMC, Pune, Maharashtra, India.
Poonam Shekhawat
Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
*Author to whom correspondence should be addressed.
Abstract
In the field of infectious diseases, the technique has been shown to be a valuable method for the identification of viruses, bacteria, fungi, and/or parasites. One such platform is the Syndromic approach, which tests for various pathogens using FilmArray panels. The paper aims to assess the impact of using the BioFire® FilmArray® within an antibiotic stewardship program on faster pathogen detection and improved antibiotic use in a tertiary care hospital in Northern India. A total of 162 samples from patients admitted to our centre with physician-labelled diagnosis of URTI, Pneumonia, Gastrointestinal infection and CNS infection were analysed by BioFire® FilmArray® from July 2022 to July 2023. A Prospective observational study. The Pneumonia Panel showed the highest positivity rate, with 38 positive cases out of a total of 39, resulting in a positivity rate of 97%. This was followed by upper respiratory specimens (59%), BCID-2 (35%), and the Meningitis Panel (17%).
Out of a total of 39 specimens (BAL/Sputum/Tracheal aspirates) tested using the Pneumonia Panel (PN Plus), 38 (97%) showed positive results, compared to conventional culture, which had a positivity rate of only 67%. The detection of viral aetiologies can guide clinicians to withhold or discontinue the antibiotics and prescribe more targeted therapy. This guided escalation, de-escalation and discontinuation decisions can strengthen the antibiotic stewardship decisions and thereby improve the patient outcomes. However, the high cost remains a limiting factor and must be included in the institutional protocol prioritization and diagnostic budgets to ensure sustainable implementation.
Keywords: BioFire®, FilmArray®, antibiotic stewardship program, meta-analytical study, North India