Comparison of antibiotic and acyclovir usage before and after the implementation of an on-site FilmArray meningitis/encephalitis panel in an academic tertiary pediatric hospital: a retrospective observational study
Open accessAbstract
Background: Prompt initiation of empiric therapy is common practice in case of suspected meningitis or encephalitis. However, in children the most common pathogens are viruses that usually do not require and are not covered by the applied anti-infective treatment. Novel multiplex PCR (mPCR) panels provide rapid on-site diagnostic testing for a variety of pathogens. This study compared empiric antibiotic and acyclovir usage before and after the introduction of an on-site FilmArray Meningitis/Encephalitis Panel (FA ME Panel). Methods: We retrospectively compared data for empiric antibiotic and acyclovir usage between pediatric patients with suspected central nervous system (CNS) infection receiving mPCR testing and a matched historical control group. Patients were matched by age and suspected CNS infection. We included all patients for whom empiric antibiotics and/or acyclovir were prescribed. Results: Each study group consisted of 46 patients with 29 (63.0%) infants and 17 (37.0%) older children. A viral pathogen was diagnosed in 5/46 (10.9%) patients in the control group (all enteroviruses) and in 14/46 (30.4%) patients in the mPCR group (enterovirus n = 9; human herpesvirus 6 (HHV-6) n = 5), (p = 0.038)). Length of Therapy (LoT) and Days of Therapy (DoT) for antibiotics were significantly lower for infants (4.0 vs. 3.0, p = 0.038 and 8.0 vs. 6.0, p = 0.015, respectively). Acyclovir therapy was significantly shorter for both, infants and older children (3.0 vs. 1.0 day, p < 0.001 for both age groups). Conclusion: The findings of our study suggest that the introduction of a FA ME Panel into clinical routine procedures is associated with a significantly reduced LoT and DoT of empiric anti-infective treatment in children with suspected meningoencephalitis. The largest effect was observed in infants.
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Implementation of the ME Panel has been shown to reduce acyclovir days of therapy in several clinical pre-post analyses.
“Implementation of the ME Panel has also been shown to reduce acyclovir days of therapy in several clinical pre-post analyses [12,13,14,15].”
The reduction in acyclovir days of therapy mirrors findings from other studies.
“This mirrors findings from other studies, as previously discussed [12,13,14,15].”
The study's results are similar to what other studies have found.
“These results are similar to what other studies have found [15,16].”
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“These results are similar to what other studies have found [15,16].”
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- Authors
- Hagen, A., Eichinger, A., Meyer-Buehn, M., Schober, T., & Huebner, J.
- Affiliations
- LMU Klinikum (DE)
- Venue
- BMC Pediatrics
- Published
- 2020-02-05
- Volume
- 20
- Issue
- 1
- Pages
- 56-56
- ISSN
- 1471-2431 (ISSN-L)
- PMC
- PMC7001287
- OpenAlex
- W3004655768
- Cited by
- 41
- References
- 45
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 15 · 2021: 7 · 2020: 5
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Pediatrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Keywords
- meningitis, encephalitis, empirical antibiotic therapy, acyclovir, FilmArray Meningitis/Encephalitis panel, multiplex PCR, on-site pathogen detection, central nervous system infection, viral meningitis, enterovirus, human herpesvirus 6, infants, antibiotic duration, antimicrobial stewardship
- MeSH terms
- Acyclovir, Adolescent, Anti-Bacterial Agents, Child, Child, Preschool, Encephalitis, Female, Hospitals, Pediatric, Humans, Infant, Male, Meningitis, Retrospective Studies, Young Adult
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