Clinical pharmacist-led multiplex polymerase chain reaction diagnostics as a tool for antimicrobial stewardship in acute exacerbations of chronic obstructive pulmonary disease

Respiratory viral infections are major triggers of acute exacerbations of chronic obstructive pulmonary disease, yet they are frequently underdiagnosed using conventional microbiological methods, contributing to empirical antimicrobial prescribing. A prospective observational study was conducted in 70 hospitalized patients to evaluate the integration of multiplex polymerase chain reaction (PCR) diagnostics into a clinical pharmacist-led antimicrobial stewardship program. Respiratory pathogens were identified in 45 patients, with multiplex PCR enabling rapid detection of respiratory viral pathogens not identified by conventional microbiological culture. Following interpretation of the molecular results by the clinical pharmacist, antibiotic discontinuation was recommended in 44 patients, while targeted antimicrobial optimization was performed in nine patients. Human rhinovirus/enterovirus was the only microbiological variable associated with prolonged hospital stay. These findings suggest that improved recognition of viral respiratory infections through rapid molecular diagnostics may support timely therapeutic decision-making and antimicrobial optimization and highlight the potential contribution of clinical pharmacists to antimicrobial stewardship.