464: EVALUATION OF ANTIMICROBIAL STEWARDSHIP WHEN USING BIOFIRE FILMARRAY PNEUMONIA PANEL

Abstract

Introduction: The goal of this study is to determine if the use of the BioFire Pneumonia Panel has led to positive impacts on antimicrobial stewardship in the intensive care units at Charleston Area Medical Center (CAMC). Methods: A total of 111 adult patients who were diagnosed with pneumonia in the intensive care unit (ICU), 59 patients diagnosed with standard of care and 52 patients diagnosed with the BioFire Pneumonia Panel, between September 1, 2018 – February 28, 2019 and September 1, 2019 – February 28, 2020, were included. For data collection, the following information was documented: length of stay, ICU length of stay, antibiotic indication, urine antigen collection and results, sputum culture collection and result, PCR collection and result, antibiotics, days of therapy, infectious disease consult, and if there was a C. diff diagnosis during admission. For each patient, their antimicrobial therapies were placed into one of eight categories regarding appropriate/inappropriateness of the therapy after a specific pathogen was or was not identified. Results: Standard of care showed more appropriate continuations in therapy with no change compared to BioFire PCR (30% vs 11%, p=0.015). Standard of care was less likely to have an appropriate escalation of therapy compared to BioFire PCR (0% vs 7.7%, p=0.03). There was no statistical difference between the two groups in appropriate discontinuation (1.7% vs 3.8%, p=0.48), appropriate de-escalation (27.1% vs 42.3%, p=0.09), inappropriate continuation (13.6% vs 13.5%, p=0.99), inappropriate escalation (8.5% vs 7.7%, p=0.88), or inappropriate de-escalation (13.6% vs 13.5%, p=0.99). The most common antibiotics used in each group were vancomycin and piperacillin/tazobactam, with the most common pathogen isolated being MRSA. Conclusions: Based on these results, the BioFire FilmArray Pneumonia Panel is a great tool that can help guide therapy, but the panel alone does not make an impact. The use of the PCR did not show a significant positive impact on antimicrobial stewardship other than escalating therapy guided toward a specific pathogen. Future directions for the use of the PCR for antimicrobial stewardship is to determine if the help of an antimicrobial stewardship pharmacist in combination with this tool can make a positive impact.