{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:30:41Z","timestamp":1787009441366,"version":"build-2736575974"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"New York-Presbyterian Hospital"},{"DOI":"10.13039\/100007273","name":"Weill Cornell Medical College","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007273","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical and Translational Science Center","award":["UL1 TR000457"],"award-info":[{"award-number":["UL1 TR000457"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2-TR-002385"],"award-info":[{"award-number":["KL2-TR-002385"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiplex polymerase chain reaction (PCR) panels allow for rapid detection or exclusion of pathogens causing meningitis and encephalitis (ME). The clinical impact of rapid multiplex PCR ME panel results on the duration of empiric antibiotic therapy is not well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective prepost study at our institution that evaluated the clinical impact of a multiplex PCR ME panel among adults with suspected bacterial meningitis who received empiric antibiotic therapy and underwent lumbar puncture in the emergency department. The primary outcome was the duration of empiric antibiotic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The positive pathogen detection rates were similar between pre- and post-multiplex PCR ME panel periods (17.5%, 24 of 137 vs 20.3%, 14 of 69, respectively). The median duration of empiric antibiotic therapy was significantly reduced in the post-multiplex PCR ME panel period compared with the pre-multiplex PCR ME panel period (34.7 vs 12.3 hours, P\u2005=\u2005.01). At any point in time, 46% more patients in the post-multiplex PCR ME panel period had empiric antibiotic therapy discontinued or de-escalated compared with the pre-multiplex PCR ME panel period (sex- and immunosuppressant use-adjusted hazard ratio 1.46, P\u2005=\u2005.01). The median hospital length of stay was shorter in the post-multiplex PCR ME panel period (3 vs 4 days, P\u2005=\u2005.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The implementation of the multiplex PCR ME panel for bacterial meningitis reduced the duration of empiric antibiotic therapy and possibly hospital length of stay compared with traditional microbiological testing methods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofab467","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T14:32:35Z","timestamp":1633012355000},"source":"Crossref","is-referenced-by-count":17,"title":["Impact of a Multiplex Polymerase Chain Reaction Panel on Duration of Empiric Antibiotic Therapy in Suspected Bacterial Meningitis"],"prefix":"10.1093","volume":"8","author":[{"given":"Justin J","family":"Choi","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars F","family":"Westblade","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA"},{"name":"Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee S","family":"Gottesdiener","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Liang","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han A","family":"Li","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham T","family":"Wehmeyer","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marshall J","family":"Glesby","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S","family":"Simon","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,30]]},"reference":[{"key":"2021100816333069800_CIT0001","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S1473-3099(10)70048-7","article-title":"Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis","volume":"10","author":"Edmond","year":"2010","journal-title":"Lancet Infect Dis"},{"key":"2021100816333069800_CIT0002","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1111\/head.13376","article-title":"Does this adult patient with jolt accentuation of headache have acute meningitis?","volume":"58","author":"Tamune","year":"2018","journal-title":"Headache"},{"key":"2021100816333069800_CIT0003","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1016\/j.ajem.2013.08.028","article-title":"Absence of jolt accentuation of headache cannot accurately rule out meningitis in adults","volume":"31","author":"Tamune","year":"2013","journal-title":"Am J Emerg Med"},{"key":"2021100816333069800_CIT0004","first-page":"CD012824","article-title":"Diagnostic test accuracy of jolt accentuation for headache in acute meningitis in the emergency setting","volume":"6","author":"Iguchi","year":"2020","journal-title":"Cochrane Database Syst. 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