{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:00:54Z","timestamp":1790618454943,"version":"4.1.0"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002583","name":"Gyeongsang National University","doi-asserted-by":"publisher","award":["GNUCHBRIF-2024-0005"],"award-info":[{"award-number":["GNUCHBRIF-2024-0005"]}],"id":[{"id":"10.13039\/501100002583","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003052","name":"Ministry of Trade, Industry and Energy","doi-asserted-by":"publisher","award":["RS-2024-00403563"],"award-info":[{"award-number":["RS-2024-00403563"]}],"id":[{"id":"10.13039\/501100003052","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rapid and accurate identification of respiratory pathogens and antimicrobial resistance is essential for optimizing antimicrobial therapy in pneumonia. Conventional culture-based diagnostics are limited by delayed turnaround times and reduced sensitivity, particularly after prior antibiotic exposure. The BioFire FilmArray Pneumonia Panel enables rapid multiplex detection of respiratory pathogens and antimicrobial resistance genes directly from clinical specimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic performance and clinical impact of the BioFire FilmArray Pneumonia Panel in hospitalized patients with pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study comparing the diagnostic performance of the FilmArray Pneumonia Panel with conventional culture using 558 bronchoalveolar lavage and sputum specimens collected between December 2022 and December 2023. Diagnostic performance, pathogen detection, antimicrobial resistance genes, and polymicrobial detection patterns were evaluated. The clinical impact of FilmArray implementation was also assessed in 494 hospitalized patients by comparing antibiotic management and clinical outcomes between the FilmArray period and pre-implementation period (January to November 2022). Multivariable regression analyses were performed to adjust for baseline differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The FilmArray panel detected a broad spectrum of bacterial pathogens, respiratory viruses, and antimicrobial resistance genes, with a substantial proportion of specimens being culture-negative but FilmArray-positive, particularly sputum specimens. Compared with the pre-implementation period, the FilmArray period showed a significantly higher frequency of result-driven antibiotic actions (40.5% vs. 26.5%; adjusted odds ratio, 1.86; 95% confidence interval [CI], 1.24\u20132.79; P\u2009=\u20090.003) and a shorter time from microbiological result reporting to antibiotic action (adjusted mean difference, \u22120.59 days; 95% CI, \u22121.07 to \u22120.10; P\u2009=\u20090.019). Measured from specimen sampling, the interval to the antibiotic action was more than three days shorter (adjusted mean difference, \u22123.53 days; 95% CI, \u22124.08 to \u22122.99; P\u2009&lt;\u20090.001), reflecting the faster turnaround of the panel (median, 0 vs. 3 days). Hospital length of stay was also shorter (adjusted mean difference, \u22121.61 days; 95% CI, \u22123.07 to \u22120.15; P\u2009=\u20090.031). However, total antibiotic exposure was modestly longer (adjusted mean difference, 1.86 days; 95% CI, 0.29\u20133.44; P\u2009=\u20090.021), and antibiotic de-escalation rates did not differ significantly between the two periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The BioFire FilmArray Pneumonia Panel improved pathogen detection and facilitated earlier and more frequent microbiology-guided antibiotic management, and was associated with a modest reduction in hospital length of stay. However, it modestly increased overall antibiotic exposure and did not increase antibiotic de-escalation. Rapid molecular diagnostics may improve the timeliness and precision of antimicrobial therapy, but their full clinical benefit is likely to be realized only when they are used as a complementary tool alongside conventional microbiological methods and integrated within a structured antimicrobial stewardship program.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358986","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:34:00Z","timestamp":1790616840000},"page":"e0358986","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic performance and clinical impact of the BioFire FilmArray Pneumonia Panel compared with conventional culture in hospitalized patients with pneumonia"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5832-5233","authenticated-orcid":true,"given":"I. Re","family":"Heo","sequence":"first","affiliation":[{"name":"Gyeongsang National University College of Medicine","place":["Jinju, Republic of Korea"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8099-8891","authenticated-orcid":true,"given":"Sunjoo","family":"Kim","sequence":"additional","affiliation":[{"name":"GC Labs","place":["Yangsan, Republic of Korea"],"department":["Department of Laboratory Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"9","key":"pone.0358986.ref001","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/S1473-3099(24)00176-2","article-title":"Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990\u20132021: a systematic analysis from the Global Burden of Disease Study 2021","volume":"24","author":"RG Bender","year":"2024","journal-title":"Lancet Infect Dis"},{"issue":"7","key":"pone.0358986.ref002","doi-asserted-by":"crossref","DOI":"10.1128\/JCM.00135-20","article-title":"Practical comparison of the BioFire FilmArray Pneumonia Panel to routine diagnostic methods and potential impact on antimicrobial stewardship in adult hospitalized patients with lower respiratory tract infections","volume":"58","author":"BW Buchan","year":"2020","journal-title":"J Clin Microbiol"},{"key":"pone.0358986.ref003","first-page":"438","article-title":"INHALE: impact of FilmArray Pneumonia Panel\u2013guided therapy on antibiotic use in critically ill patients","volume":"22","author":"J High","year":"2021","journal-title":"Trials"},{"issue":"7","key":"pone.0358986.ref004","doi-asserted-by":"crossref","DOI":"10.1128\/JCM.00128-20","article-title":"Multicenter evaluation of the BioFire FilmArray Pneumonia\/Pneumonia Plus Panel for detection and quantification of agents of lower respiratory tract infection","volume":"58","author":"CN Murphy","year":"2020","journal-title":"J Clin Microbiol"},{"issue":"3","key":"pone.0358986.ref005","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.0830","article-title":"Diagnostic stewardship in community-acquired pneumonia with syndromic molecular testing: a randomized clinical trial","volume":"7","author":"DL Markussen","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"8","key":"pone.0358986.ref006","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1007\/s10096-021-04195-5","article-title":"Multinational evaluation of the BioFire\u00ae FilmArray\u00ae Pneumonia plus Panel as compared to standard of care testing","volume":"40","author":"and the EME Evaluation Program Collaborative","year":"2021","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"9","key":"pone.0358986.ref007","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1016\/j.cmi.2020.11.014","article-title":"Multicentric evaluation of BioFire FilmArray Pneumonia Panel for rapid bacteriological documentation of pneumonia","volume":"27","author":"N Gastli","year":"2021","journal-title":"Clin Microbiol Infect"},{"issue":"1","key":"pone.0358986.ref008","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/cid\/ciw649","article-title":"The effect of molecular rapid diagnostic testing on clinical outcomes in bloodstream infections: a systematic review and meta-analysis","volume":"64","author":"TT Timbrook","year":"2017","journal-title":"Clin Infect Dis"},{"issue":"1","key":"pone.0358986.ref009","doi-asserted-by":"crossref","first-page":"1900057","DOI":"10.1183\/13993003.00057-2019","article-title":"Broad-spectrum antibiotic use and poor outcomes in community-onset pneumonia: a cohort study","volume":"54","author":"BJ Webb","year":"2019","journal-title":"Eur Respir J"},{"key":"pone.0358986.ref010","article-title":"Review of rapid diagnostic tests used by antimicrobial stewardship programs","author":"KA Bauer","year":"2014","journal-title":"Clin Infect Dis"},{"issue":"3","key":"pone.0358986.ref011","doi-asserted-by":"crossref","first-page":"115246","DOI":"10.1016\/j.diagmicrobio.2020.115246","article-title":"Enhanced detection of community-acquired pneumonia pathogens with the BioFire\u00ae Pneumonia FilmArray\u00ae Panel","volume":"99","author":"DN Gilbert","year":"2021","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"3","key":"pone.0358986.ref012","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.jmii.2024.02.010","article-title":"Application of a multiplex molecular pneumonia panel and real-world impact on antimicrobial stewardship among patients with hospital-acquired and ventilator-associated pneumonia in intensive care units","volume":"57","author":"C-L Chen","year":"2024","journal-title":"J Microbiol Immunol Infect"},{"key":"pone.0358986.ref013","unstructured":"Dessajan S, Roux D, Luyt CE, Trouillet JL, Chastre J, Wolff M, et al. Assessing FilmArray Pneumonia+ panel dynamics during antibiotic treatment to predict clinical success in ICU patients with ventilated hospital-acquired pneumonia and ventilator-associated pneumonia. Ann Intensive Care. 2023;13:90."},{"issue":"8","key":"pone.0358986.ref014","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad382","article-title":"Implementation of a rapid multiplex polymerase chain reaction pneumonia panel and subsequent antibiotic de-escalation","volume":"10","author":"MM Miller","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"pone.0358986.ref015","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.ijid.2020.03.024","article-title":"Evaluation of the BioFire FilmArray Pneumonia Panel for rapid detection of respiratory bacterial pathogens and antibiotic resistance genes in sputum and endotracheal aspirate specimens","volume":"95","author":"IY Yoo","year":"2020","journal-title":"Int J Infect Dis"},{"issue":"6","key":"pone.0358986.ref016","first-page":"101300","article-title":"Performance evaluation of a PCR panel (FilmArray\u00ae Pneumonia Plus) for detection of respiratory bacterial pathogens in respiratory specimens: A systematic review and meta-analysis","volume":"42","author":"A-C Moy","year":"2023","journal-title":"Anaesth Crit Care Pain Med"},{"issue":"1","key":"pone.0358986.ref017","article-title":"Performance of BioFire FilmArray Pneumonia Panel in real-world clinical practice","volume":"13","author":"MM Hellou","year":"2025","journal-title":"Microbiol Spectr"},{"issue":"4","key":"pone.0358986.ref018","article-title":"Clinical relevance of the BioFire FilmArray Pneumonia Panel among hospitalized patients","volume":"30","author":"KK S\u00f8gaard","year":"2024","journal-title":"Clin Microbiol Infect"},{"issue":"12","key":"pone.0358986.ref019","doi-asserted-by":"crossref","first-page":"100928","DOI":"10.1016\/S2666-5247(24)00170-8","article-title":"Rapid multiplex PCR panel for pneumonia in hospitalised patients with suspected pneumonia in the USA: a single-centre, open-label, pragmatic, randomised controlled trial","volume":"5","author":"A Virk","year":"2024","journal-title":"Lancet Microbe"},{"issue":"3","key":"pone.0358986.ref020","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1093\/jpids\/piae014","article-title":"Practice versus potential: the impact of the BioFire FilmArray Pneumonia Panel on antibiotic use in children","volume":"13","author":"AS Plattner","year":"2024","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"2","key":"pone.0358986.ref021","article-title":"Performance evaluation of the BioFire FilmArray Pneumonia Panel compared with standard-of-care cultures","volume":"13","author":"M Gemoules","year":"2025","journal-title":"Microbiol Spectr"},{"issue":"2","key":"pone.0358986.ref022","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1007\/s00134-024-07772-2","article-title":"INHALE WP3, a multicentre, open-label, pragmatic randomised controlled trial assessing the impact of rapid, ICU-based, syndromic PCR, versus standard-of-care on antibiotic stewardship and clinical outcomes in hospital-acquired and ventilator-associated pneumonia","volume":"51","author":"VI Enne","year":"2025","journal-title":"Intensive Care Med"},{"issue":"1","key":"pone.0358986.ref023","doi-asserted-by":"crossref","DOI":"10.1017\/ash.2025.57","article-title":"Single-center retrospective evaluation of a polymerase chain reaction-based pneumonia panel on antibiotic therapy optimization at a community hospital","volume":"5","author":"L Manda","year":"2025","journal-title":"Antimicrob Steward Healthc Epidemiol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358986","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:34:08Z","timestamp":1790616848000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358986"}},"subtitle":[],"editor":[{"given":"Flora","family":"De Conto","sequence":"first","affiliation":[{"name":"Universit\u00e0 degli Studi di Parma: Universita degli Studi di Parma","place":["ITALY"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":23,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0358986","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}