{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:14:22Z","timestamp":1793661262104,"version":"4.5.1"},"reference-count":100,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Pneumonia is common in the intensive care unit (ICU), infecting 27% of all critically ill patients. Given the high prevalence of this disease state in the ICU, optimizing antimicrobial therapy while minimizing toxicities is of utmost importance. Inappropriate antimicrobial use can increase the risk of antimicrobial resistance, Clostridiodes difficile infection, allergic reaction, and other complications from antimicrobial use (e.g., QTc prolongation, thrombocytopenia). This review article aims to discuss methods to optimize antimicrobial treatment in patients with pneumonia, including the following: procalcitonin use, utilization of methicillin-resistant Staphylococcus aureus nares testing to determine need for vancomycin therapy, utilization of the Biofire\u00ae FilmArray\u00ae pneumonia polymerase chain reaction (PCR), and microbiology reporting techniques.<\/jats:p>","DOI":"10.3390\/antibiotics12020295","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T05:33:53Z","timestamp":1675229633000},"page":"295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Antimicrobial Stewardship Techniques for Critically Ill Patients with Pneumonia"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7137-6529","authenticated-orcid":false,"given":"Jenna","family":"Adams","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RaeAnn","family":"Hirschy","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Konopka","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Meckel","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Benanti","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Kuhrau","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3441-301X","authenticated-orcid":false,"given":"Fritzie","family":"Albarillo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2128-5813","authenticated-orcid":false,"given":"Maressa","family":"Santarossa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8415-0836","authenticated-orcid":false,"given":"Julia","family":"Sapozhnikov","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Hoff","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan A","family":"Rech","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, USA"},{"name":"Department of Emergency Medicine, Stritch School of Medicine, Loyola University Chicago, 2160 S First Ave, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1128\/CMR.00051-05","article-title":"Ventilator-associated pneumonia: Diagnosis, treatment, and prevention","volume":"19","author":"Koenig","year":"2006","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1093\/cid\/ciw353","article-title":"Management of Adults with Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"Kalil","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1179\/joc.2003.15.6.568","article-title":"Modification of patients\u2019 endogenous bacterial flora during hospitalization in a large teaching hospital in Naples","volume":"15","author":"Esposito","year":"2003","journal-title":"J. Chemother."},{"key":"ref_5","unstructured":"Mohanad, A. (2022, December 15). 5 Most Common Hospital Acquired Infections (HAIs). Available online: https:\/\/inivos.com\/blog\/5-most-common-hospital-acquired-infections-hais\/."},{"key":"ref_6","unstructured":"(2022, December 15). About Antimicrobial Resistance, Available online: https:\/\/www.cdc.gov\/drugresistance\/about.html."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1017\/ice.2019.381","article-title":"Evaluation of a ceiling effect on the association of new resistance development to antipseudomonal beta-lactam exposure in the critically ill","volume":"41","author":"Teshome","year":"2020","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1093\/jac\/dkaa463","article-title":"Identification of thresholds in relationships between specific antibiotic use and carbapenem-resistant Acinetobacter baumannii (CRAb) incidence rates in hospitalized patients in Jordan","volume":"76","author":"Hayajneh","year":"2021","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/BF01740811","article-title":"Procalcitonin\u2014A new indicator of the systemic response to severe infections","volume":"25","author":"Karzai","year":"1997","journal-title":"Infection"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1097\/CCM.0B013E318165BABB","article-title":"Procalcitonin assay in systemic inflammation, infection, and sepsis: Clinical utility and limitations","volume":"36","author":"Becker","year":"2008","journal-title":"Crit. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/S0140-6736(04)15591-8","article-title":"Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: Cluster-randomised, single-blinded intervention trial","volume":"363","author":"Bingisser","year":"2004","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1093\/cid\/cix317","article-title":"Procalcitonin as a Marker of Etiology in Adults Hospitalized with Community-Acquired Pneumonia","volume":"65","author":"Self","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1097\/CCM.0000000000002321","article-title":"Serial Procalcitonin Predicts Mortality in Severe Sepsis Patients: Results From the Multicenter Procalcitonin MOnitoring SEpsis (MOSES) Study","volume":"45","author":"Schuetz","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1093\/cid\/ciz545","article-title":"Procalcitonin to Distinguish Viral from Bacterial Pneumonia: A Systematic Review and Meta-analysis","volume":"70","author":"Kamat","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1056\/NEJMoa1802670","article-title":"Procalcitonin-Guided Use of Antibiotics for Lower Respiratory Tract Infection","volume":"379","author":"Huang","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/S0140-6736(09)61879-1","article-title":"Use of procalcitonin to reduce patients\u2019 exposure to antibiotics in intensive care units (PRORATA trial): A multicentre randomised controlled trial","volume":"375","author":"Bouadma","year":"2010","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e1063","DOI":"10.1097\/CCM.0000000000005337","article-title":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021","volume":"49","author":"Evans","year":"2021","journal-title":"Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/j.cmi.2014.12.026","article-title":"The diagnostic accuracy of procalcitonin for bacteraemia: A systematic review and meta-analysis","volume":"21","author":"Hoeboer","year":"2015","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"ofaa096","DOI":"10.1093\/ofid\/ofaa096","article-title":"Low Sensitivity of Procalcitonin for Bacteremia at an Academic Medical Center: A Cautionary Tale for Antimicrobial Stewardship","volume":"7","author":"Goodlet","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_20","first-page":"564","article-title":"Correlation of serum procalcitonin with the severity of skin and skin structure infections\u2014A pilot study","volume":"10","author":"Eder","year":"2012","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_21","first-page":"1605","article-title":"Procalcitonin increase after endotoxin injection in normal subjects","volume":"79","author":"Dandona","year":"1994","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Muller, B., Harbarth, S., Stolz, D., Bingisser, R., Mueller, C., Leuppi, J., Nusbaumer, C., Tamm, M., and Christ-Crain, M. (2007). Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia. BMC Infect. Dis., 7.","DOI":"10.1186\/1471-2334-7-10"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"207","DOI":"10.5114\/reum.2016.62476","article-title":"Limited diagnostic value of procalcitonin in early diagnosis of adult onset Still\u2019s disease","volume":"54","author":"Gowin","year":"2016","journal-title":"Reumatologia"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1086\/322031","article-title":"Effects of anti-inflammatory agents on serum levels of calcitonin precursors during human experimental endotoxemia","volume":"184","author":"Preas","year":"2001","journal-title":"J. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Mazaheri, T., Ranasinghe, R., Al-Hasani, W., Luxton, J., Kearney, J., Manning, A., Dimitriadis, G.K., Mare, T., and Vincent, R.P. (2022). A cytokine panel and procalcitonin in COVID-19, a comparison between intensive care and non-intensive care patients. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0266652"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s13613-016-0215-8","article-title":"Prognostic value of procalcitonin in patients after elective cardiac surgery: A prospective cohort study","volume":"6","author":"Klingele","year":"2016","journal-title":"Ann. Intensive Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1097\/MAJ.0b013e3182425ec3","article-title":"A comparison of acute kidney injury classifications in patients with severe sepsis and septic shock","volume":"344","author":"Huh","year":"2012","journal-title":"Am. J. Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"R110","DOI":"10.1186\/cc6997","article-title":"Acute kidney injury in intensive care unit patients: A comparison between the RIFLE and the Acute Kidney Injury Network classifications","volume":"12","author":"Lopes","year":"2008","journal-title":"Crit. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1093\/ndt\/gfq332","article-title":"Defining urine output criterion for acute kidney injury in critically ill patients","volume":"26","author":"Macedo","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1515\/cclm-2020-0931","article-title":"Association of kidney function with effectiveness of procalcitonin-guided antibiotic treatment: A patient-level meta-analysis from randomized controlled trials","volume":"59","author":"Heilmann","year":"2020","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e23065","DOI":"10.1002\/jcla.23065","article-title":"Elevated serum procalcitonin level in patients with chronic kidney disease without infection: A case-control study","volume":"34","author":"Wu","year":"2020","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_32","first-page":"411","article-title":"Pro-calcitonin and inflammation in chronic hemodialysis","volume":"73","author":"Trimarchi","year":"2013","journal-title":"Medicina"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.medin.2017.12.004","article-title":"Relationship between acute kidney injury and serum procalcitonin (PCT) concentration in critically ill patients with influenza infection","volume":"42","author":"Rodriguez","year":"2018","journal-title":"Med. Intensiva"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1097\/CCM.0000000000002953","article-title":"Systematic Review and Meta-Analysis of Procalcitonin-Guidance versus Usual Care for Antimicrobial Management in Critically Ill Patients: Focus on Subgroups Based on Antibiotic Initiation, Cessation, or Mixed Strategies","volume":"46","author":"Lam","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"R97","DOI":"10.1186\/cc4934","article-title":"Morbidity and cost burden of methicillin-resistant Staphylococcus aureus in early onset ventilator-associated pneumonia","volume":"10","author":"Shorr","year":"2006","journal-title":"Crit. Care"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Colaneri, M., Di Carlo, D., Amatu, A., Marvulli, L.N., Corbella, M., Petazzoni, G., Cambieri, P., Muzzi, A., Bandi, C., and Di Matteo, A. (2022). Ventilator-Associated Pneumonia Due to MRSA vs. MSSA: What Should Guide Empiric Therapy?. Antibiotics, 11.","DOI":"10.21203\/rs.3.rs-1373282\/v1"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1093\/ajhp\/zxab109","article-title":"Evaluation of the timing of MRSA PCR nasal screening: How long can a negative assay be used to rule out MRSA-positive respiratory cultures?","volume":"78","author":"Turner","year":"2021","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/CCM.0b013e3182a66bb8","article-title":"The prevalence and significance of methicillin-resistant Staphylococcus aureus colonization at admission in the general ICU Setting: A meta-analysis of published studies","volume":"42","author":"Ziakas","year":"2014","journal-title":"Crit. Care Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1128\/AAC.01805-13","article-title":"Predictive value of methicillin-resistant Staphylococcus aureus (MRSA) nasal swab PCR assay for MRSA pneumonia","volume":"58","author":"Dangerfield","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.2147\/IDR.S351832","article-title":"Evaluation of the Negative Predictive Value of Methicillin-Resistant Staphylococcus aureus Nasal Swab Screening in the Medical Intensive Care Units and Its Effect on Antibiotic Duration","volume":"15","author":"Tai","year":"2022","journal-title":"Infect. Drug Resist."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/cid\/ciy024","article-title":"The Clinical Utility of Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Screening to Rule Out MRSA Pneumonia: A Diagnostic Meta-analysis with Antimicrobial Stewardship Implications","volume":"67","author":"Parente","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1017\/ice.2017.308","article-title":"The Role of Negative Methicillin-Resistant Staphylococcus aureus Nasal Surveillance Swabs in Predicting the Need for Empiric Vancomycin Therapy in Intensive Care Unit Patients","volume":"39","author":"Chotiprasitsakul","year":"2018","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.ajic.2014.05.026","article-title":"Nasal screening is useful in excluding methicillin-resistant Staphylococcus aureus in ventilator-associated pneumonia","volume":"42","author":"Langsjoen","year":"2014","journal-title":"Am. J. Infect. Control"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1002\/phar.2497","article-title":"Performance of nasal methicillin-resistant Staphylococcus aureus screening for intra-abdominal infections in critically ill adult patients","volume":"41","author":"Bennett","year":"2021","journal-title":"Pharmacotherapy"},{"key":"ref_45","first-page":"e6378","article-title":"Impact of a Pharmacist-driven Methicillin-resistant Staphylococcus aureus Polymerase Chain Reaction Nasal Swab Protocol on the De-escalation of Empiric Vancomycin in Patients with Pneumonia in a Rural Healthcare Setting","volume":"11","author":"Dadzie","year":"2019","journal-title":"Cureus"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.mayocpiqo.2020.05.002","article-title":"Pharmacist-Driven MRSA Nasal PCR Screening and the Duration of Empirical Vancomycin Therapy for Suspected MRSA Respiratory Tract Infections","volume":"4","author":"Woolever","year":"2020","journal-title":"Mayo Clin. Proc. Innov. Qual. Outcomes"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2236","DOI":"10.1093\/ajhp\/zxab296","article-title":"Effect of rapid methicillin-resistant Staphylococcus aureus nasal polymerase chain reaction screening on vancomycin use in the intensive care unit","volume":"78","author":"Diep","year":"2021","journal-title":"Am. J. Health Pharm."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Marinucci, V., Louzon, P.R., Carr, A., Hayes, J., Sniffen, J., and Ruiz, A.L. (2022). Pharmacist-Driven Methicillin-Resistant S. aureus Polymerase Chain Reaction Testing for Pneumonia. Ann. Pharmacother., 10600280221121144.","DOI":"10.1177\/10600280221121144"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"ofab099","DOI":"10.1093\/ofid\/ofab099","article-title":"Discontinuation Patterns and Cost Avoidance of a Pharmacist-Driven Methicillin-Resistant Staphylococcus aureus Nasal Polymerase Chain Reaction Testing Protocol for De-escalation of Empiric Vancomycin for Suspected Pneumonia","volume":"8","author":"Meng","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.cmi.2017.06.017","article-title":"Evaluation of vancomycin MIC creep in methicillin-resistant Staphylococcus aureus infections-a systematic review and meta-analysis","volume":"24","author":"Diaz","year":"2018","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_51","first-page":"269","article-title":"Vancomycin Resistance in Staphylococcus aureus","volume":"90","author":"McGuinness","year":"2017","journal-title":"Yale J. Biol. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"S153","DOI":"10.1093\/cid\/cir1060","article-title":"Use and evaluation of molecular diagnostics for pneumonia etiology studies","volume":"54","author":"Bhat","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1586\/14737159.2016.1156536","article-title":"How recent advances in molecular tests could impact the diagnosis of pneumonia","volume":"16","author":"Murdoch","year":"2016","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_54","unstructured":"Yilmaz, G., Buccambuso, M., Edwards, T., Hockin, M., Alberti-Segui, C., Weber, C., Dubrost, C., Arce, J., Lems, R., and O\u2019Connor, L. (2018, January 21\u201324). Analytical reactivity of the FilmArray\u00ae Pneumonia Panel plus for identification of viruses, bacteria and antimicrobial resistance genes from lower respiratory tract samples. Proceedings of the 28th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), Madrid, Spain."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2744","DOI":"10.1093\/cid\/ciaa508","article-title":"Molecular Testing for Acute Respiratory Tract Infections: Clinical and Diagnostic Recommendations from the IDSA\u2019s Diagnostics Committee","volume":"71","author":"Hanson","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_56","unstructured":"(2022, December 15). The BioFire FilmArray Pneumonia (PN) Panel: Syndromic Infectious Disease Testing for Pneumonia. Available online: https:\/\/www.biofiredx.com\/products\/the-filmarray-panels\/filmarray-pneumonia\/."},{"key":"ref_57","unstructured":"(2022, December 15). Unyvero Applications. Available online: https:\/\/curetis.com\/products\/applications\/#hpn."},{"key":"ref_58","unstructured":"(2022, December 15). NxTAG Respiratory Pathogen Panel. Available online: https:\/\/www.luminexcorp.com\/nxtag-respiratory-pathogen-panel\/."},{"key":"ref_59","unstructured":"(2022, December 15). Seeplex PneumoBacter ACE Detection. Available online: https:\/\/www.seegene.com\/assays\/seeplex_pneumobacter_ace_detection."},{"key":"ref_60","unstructured":"(2022, December 15). NeoPlex RB-8 Detection Kit. Available online: https:\/\/laboshop.ae\/product\/neoplex-rb-8-detection-kit765."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1128\/JCM.00549-16","article-title":"Impact of Early Detection of Respiratory Viruses by Multiplex PCR Assay on Clinical Outcomes in Adult Patients","volume":"54","author":"Rappo","year":"2016","journal-title":"J. Clin. Microbiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"S134","DOI":"10.1093\/cid\/ciu547","article-title":"Review of rapid diagnostic tests used by antimicrobial stewardship programs","volume":"59","author":"Bauer","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1186\/s13054-020-03114-y","article-title":"Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia","volume":"24","author":"Monard","year":"2020","journal-title":"Crit. Care"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/S2213-2600(22)00086-8","article-title":"Fast multiplex bacterial PCR of bronchoalveolar lavage for antibiotic stewardship in hospitalised patients with pneumonia at risk of Gram-negative bacterial infection (Flagship II): A multicentre, randomised controlled trial","volume":"10","author":"Darie","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1186\/s13054-020-03067-2","article-title":"Performance and impact of a multiplex PCR in ICU patients with ventilator-associated pneumonia or ventilated hospital-acquired pneumonia","volume":"24","author":"Bouadma","year":"2020","journal-title":"Crit. Care"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.3389\/fmicb.2020.02080","article-title":"Evaluation of the FilmArray\u00ae Pneumonia Plus Panel for Rapid Diagnosis of Hospital-Acquired Pneumonia in Intensive Care Unit Patients","volume":"11","author":"Cremet","year":"2020","journal-title":"Front. Microbiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"804611","DOI":"10.3389\/fcimb.2022.804611","article-title":"Potential Impact of Rapid Multiplex PCR on Antimicrobial Therapy Guidance for Ventilated Hospital-Acquired Pneumonia in Critically Ill Patients, A Prospective Observational Clinical and Economic Study","volume":"12","author":"Guillotin","year":"2022","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"920","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":"Buchan","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.jmii.2019.10.009","article-title":"Performance of a multiplex PCR pneumonia panel for the identification of respiratory pathogens and the main determinants of resistance from the lower respiratory tract specimens of adult patients in intensive care units","volume":"52","author":"Lee","year":"2019","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_70","unstructured":"Ghadikolai, A., Sinclair, W., Wallentine, J., Carlquist, J., and Lopansri, B.K. (2022, December 28). A Comparison of Two Molecular Panels for Culture Independent Detection of Lower Respiratory Tract Pathogens. Available online: https:\/\/www.opgen.com\/2021\/05\/27\/a-comparison-of-two-molecular-panels-for-culture-independent-detection-of-lower-respiratory-tract-pathogens-2\/."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.diagmicrobio.2016.06.010","article-title":"\u2018Sample-in, answer-out\u2019? Evaluation and comprehensive analysis of the Unyvero P50 pneumonia assay","volume":"86","author":"Personne","year":"2016","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Schulte, B., Eickmeyer, H., Heininger, A., Juretzek, S., Karrasch, M., Denis, O., Roisin, S., Pletz, M.W., Klein, M., and Barth, S. (2014). Detection of pneumonia associated pathogens using a prototype multiplexed pneumonia test in hospitalized patients with severe pneumonia. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0110566"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1007\/s10096-022-04466-9","article-title":"Evaluation of a pneumonia multiplex PCR panel for detection of bacterial respiratory tract pathogens from serial specimens collected from hospitalized COVID-19 patients","volume":"41","author":"Tellapragada","year":"2022","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"106259","DOI":"10.1016\/j.mimet.2021.106259","article-title":"Respiratory bacterial co-infections in intensive care unit-hospitalized COVID-19 patients: Conventional culture vs BioFire FilmArray pneumonia Plus panel","volume":"186","author":"Foschi","year":"2021","journal-title":"J. Microbiol. Methods"},{"key":"ref_75","unstructured":"Kerr, S., Graue, C., Broadbent, K., Balada-Llasat, J.M., and Carroll, A. (2018, January 21\u201324). Clinical evaluation of the BioFire FilmArray Pneumonia Panel plus. Proceedings of the European Society of Clinical Microbiology and Infectious Diseases Meeting, Basel, Switzerland."},{"key":"ref_76","unstructured":"Faron, M.L., Mahmutoglu, D., Huang, A., Balada-Llasat, J.M., Relich, R.F., Humphries, R., Miller, S., Harrington, A., Murphy, C., and Leber, A. (2018, January 21\u201324). Clinical evaluation of a semi-quantitative multiplex molecular assay for the identification of bacteria, viruses and fungi in lower respiratory specimens. Proceedings of the European Society of Clinical Microbiology and Infectious Diseases Meeting, Basel, Switzerland."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1128\/JCM.41.1.495-497.2003","article-title":"Detection and treatment of bloodstream infection: Laboratory reporting and antimicrobial management","volume":"41","author":"Munson","year":"2003","journal-title":"J. Clin. Microbiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.cll.2020.07.001","article-title":"Modern Blood Culture: Management Decisions and Method Options","volume":"40","author":"Gonzalez","year":"2020","journal-title":"Clin. Lab. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1017\/ice.2021.109","article-title":"Asymptomatic bacterisputia: Rethinking diagnostic stewardship in pneumonia","volume":"42","author":"Albin","year":"2021","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e226136","DOI":"10.1001\/jamanetworkopen.2022.6136","article-title":"Effect of Gram Stain-Guided Initial Antibiotic Therapy on Clinical Response in Patients with Ventilator-Associated Pneumonia: The GRACE-VAP Randomized Clinical Trial","volume":"5","author":"Yoshimura","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"ofy162","DOI":"10.1093\/ofid\/ofy162","article-title":"Microbiology Comment Nudge Improves Pneumonia Prescribing","volume":"5","author":"Musgrove","year":"2018","journal-title":"Open Forum Infect. Dis."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e02564-18","DOI":"10.1128\/AAC.02564-18","article-title":"A Combination Antibiogram Evaluation for Pseudomonas aeruginosa in Respiratory and Blood Sources from Intensive Care Unit (ICU) and Non-ICU Settings in U.S. Hospitals","volume":"63","author":"Puzniak","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"20499361211011373","DOI":"10.1177\/20499361211011373","article-title":"Antimicrobial stewardship and antibiograms: Importance of moving beyond treaditional antibiograms","volume":"8","author":"Klinker","year":"2021","journal-title":"Therapeutic Adv. Infect. Dis."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1128\/JCM.01782-06","article-title":"Comparison of disk diffusion, VITEK 2; broth microdilution antimicrobial susceptibility test results for unusual species of Enterobacteriaceae","volume":"45","author":"Stone","year":"2007","journal-title":"J. Clin. Microbiol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"e0300720","DOI":"10.1128\/jcm.03007-20","article-title":"Stop Waiting for Tomorrow: Disk Diffusion Performed on Early Growth Is an Accurate Method for Antimicrobial Susceptibility Testing with Reduced Turnaround Time","volume":"60","author":"Webber","year":"2022","journal-title":"J. Clin. Microbiol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"e00437-18","DOI":"10.1128\/JCM.00437-18","article-title":"The Continued Value of Disk Diffusion for Assessing Antimicrobial Susceptibility in Clinical Laboratories: Report from the Clinical and Laboratory Standards Institute Methods Development and Standardization Working Group","volume":"56","author":"Humphries","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.cmi.2020.10.001","article-title":"Antibiotic susceptibility reporting and association with antibiotic prescribing: A cohort study","volume":"27","author":"Langford","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"ofaa002","DOI":"10.1093\/ofid\/ofaa002","article-title":"Out of Sight-Out of Mind: Impact of Cascade Reporting on Antimicrobial Usage","volume":"7","author":"Liao","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.jiph.2014.09.004","article-title":"Restrictive reporting of selected antimicrobial susceptibilities influences clinical prescribing","volume":"8","author":"Momattin","year":"2015","journal-title":"J. Infect. Public Health"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/j.cmi.2020.07.016","article-title":"Bacterial co-infection and secondary infection in patients with COVID-19: A living rapid review and meta-analysis","volume":"26","author":"Langford","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jinf.2020.05.046","article-title":"Co-infections in people with COVID-19: A systematic review and meta-analysis","volume":"81","author":"Lansbury","year":"2020","journal-title":"J. Infect."},{"key":"ref_92","unstructured":"Wei, W., Ortwine, J.K., Mang, N.S., Joseph, C., and Hall, B.C. (2022, December 21). Limited Role for Antibiotics in COVID-19: Scarce Evidence of Bacterial Coinfection. Available online: https:\/\/www.medrxiv.org\/content\/10.1101\/2020.06.16.20133181v1."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.cca.2020.03.004","article-title":"Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis","volume":"505","author":"Lippi","year":"2020","journal-title":"Clin. Chim. Acta"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"106051","DOI":"10.1016\/j.ijantimicag.2020.106051","article-title":"Procalcitonin levels in COVID-19 patients","volume":"56","author":"Hu","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"198171","DOI":"10.1016\/j.virusres.2020.198171","article-title":"IFN-gamma is an independent risk factor associated with mortality in patients with moderate and severe COVID-19 infection","volume":"289","author":"Gadotti","year":"2020","journal-title":"Virus Res."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Carbonell, R., Moreno, G., Mart\u00edn-Loeches, I., Gomez-Bertomeu, F., Sarvis\u00e9, C., G\u00f3mez, J., Bod\u00ed, M., D\u00edaz, E., Papiol, E., and Trefler, S. (2021). Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia. Antibiotics, 10.","DOI":"10.3390\/antibiotics10040350"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"R44","DOI":"10.1186\/cc13760","article-title":"Procalcitonin for diagnosis of bacterial pneumonia in critically ill patients during 2009 H1N1 influenza pandemic: A prospective cohort study, systematic review and individual patient data meta-analysis","volume":"18","author":"Pfister","year":"2014","journal-title":"Crit. Care"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"405","DOI":"10.3390\/pathophysiology29030032","article-title":"Pathophysiology of Methicillin-Resistant Staphylococcus aureus Superinfection in COVID-19 Patients","volume":"29","author":"Habib","year":"2022","journal-title":"Pathophysiology"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1093\/cid\/ciab688","article-title":"The Impact of Coronavirus Disease 2019 (COVID-19) on Healthcare-Associated Infections","volume":"74","author":"Baker","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.idc.2010.11.011","article-title":"Antimicrobial stewardship","volume":"25","author":"Tamma","year":"2011","journal-title":"Infect. Dis. Clin. N. Am."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/12\/2\/295\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:21:04Z","timestamp":1760120464000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/12\/2\/295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,1]]},"references-count":100,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["antibiotics12020295"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics12020295","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,1]]}}}