Abstract Rationale Community-acquired pneumonia (CAP) remains a significant cause of hospitalization and is frequently managed empirically due to delays in pathogen identification. Rapid diagnostic tools, such as respiratory multiplex PCR assay (pneumonia panel) combined with procalcitonin monitoring, hold promise for improving antibiotic stewardship and patient outcomes in high-risk CAP (CAP-HR). The objectives of the study are to evaluate the impact of broad panel respiratory multiplex PCR (Pneumonia panel) and serial Procalcitonin monitoring on the reduction of antibiotic exposure on patients with community acquired pneumonia-high risk, as compared to the standard of care treatment. Methods This pilot study employed an ambispective observational cohort design, analyzing data from 64 intubated CAP-HR patients admitted to the ICU between March 2024 and March 2025. 32 patients received standard-of-care diagnostics (control arm), while 32 patients received a pneumonia panel and serial procalcitonin monitoring in addition to standard care (intervention arm). The primary outcome was the number of antibiotic-free days, antibiotic duration, and time to antibiotic de-escalation. Secondary outcomes included ventilator-free days, ICU and hospital length of stay, morbidity, mortality, and total treatment costs. Results The intervention arm demonstrated a significant increase in antibiotic-free days (2.25 ± 2.86 vs. 0.63 ± 1.29, p = 0.005), a significant reduction in composite morbidity (34.4% vs. 68.8%, p = 0.006), and a significant reduction in in-hospital mortality (9.4% vs. 50.0%, p 0.001) (Table 1). No statistically significant differences were observed in antibiotic duration, time to de-escalation, ventilator-free days, or length of stay. Total treatment costs did not differ significantly between the two arms. Conclusion The implementation of a pneumonia panel combined with serial procalcitonin monitoring in intubated CAP-HR patients significantly improved antibiotic utilization, reduced morbidity, and decreased in-hospital mortality. While the intervention did not impact all clinical outcomes or treatment costs, these findings support the integration of rapid diagnostics into antibiotic stewardship programs to optimize antibiotic selection and improve patient outcomes. This abstract is funded by: Research and Biotechnology Group - St. Luke’s Medical Center
Supan et al. (2026) studied this question.