Syndromic Multiplex Polymerase Chain Reaction (mPCR) Testing and Antimicrobial Stewardship: Current Practice and Future Directions

• Published in: Current infectious disease reports 2021-04, Vol.23 (4), p.5-5, Article 5
• Main Authors: Rader, Theodore S., Stevens, Michael P., Bearman, Gonzalo
• Format: Article
• Language: English
• Subjects: Algorithms; Antibiotics; Antimicrobial agents; Central nervous system; Drug therapy; Healthcare Associated Infections (G Bearman and D Morgan; Healthcare Associated Infections (G Bearman and D Morgan, Section Editors); Infectious Diseases; Medicine; Medicine & Public Health; Polymerase chain reaction; Section Editors; Topical Collection on Healthcare Associated Infections
• ISSN: 1523-3847; 1534-3146
• DOI: 10.1007/s11908-021-00748-z

Purpose of Review Syndromic multiplex polymerase chain reaction (mPCR) panels offer the antimicrobial steward a rapid tool for optimizing and de-escalating antimicrobials. In this review, we analyze the role of syndromic mPCR in respiratory, gastrointestinal, and central nervous system infections within the context of antimicrobial stewardship efforts. Recent Findings For all mPCR syndromic panels, multiple studies analyzed the pre-and-post implementation impact of mPCR on antimicrobial utilization. Prospective studies and trials of respiratory mPCR stewardship interventions, including diagnostic algorithms, educational efforts, co-testing with procalcitonin, and targeted provider feedback currently exist. For gastrointestinal and cerebrospinal fluid mPCR, fewer peer-reviewed reports exist for the use of mPCR in antimicrobial stewardship. These studies demonstrated an inconsistent trend towards decreasing antibiotic use with mPCR. This is further limited by a lack of statistical significance, the absence of controlled, prospective trials, and issues with data generalizability. Summary Antibiotic overuse may improve when mPCR is coupled with electronic medical record algorithm-based approaches and direct provider feedback by an antimicrobial stewardship professional. mPCR may prove a useful tool for antimicrobial stewardship but future studies are needed to define the best practice for its utilization.