News: Pneumonia PCR testing led to faster targeted treatment in the ED, study says

For people with suspected community-acquired pneumonia (CAP) in the emergency department (ED), routine polymerase chain reaction (PCR) testing on lower respiratory tract samples led to faster and more targeted treatment, according to a study published in JAMA Network Open. In the first 48 hours, 35% of patients who received PCR tests also received pathogen-directed treatment compared to 13.4% of those who received standard of care, MedPage Today reported.

The study was a randomized, single-center trial conducted within the ED of Haukeland University Hospital in Bergen, Norway, with recruitment of 374 individuals from 2020 to 2022. In those receiving a pathogen-directed agent within 48 hours, the intervention group received treatment significantly sooner. The trial found that, among patients with confirmed CAP, rapid PCR was associated with both greater pathogen-directed treatment (47.4% vs 15.5%) and faster time to such treatment (a median of 29.9 vs. 42.3 hours) within 48 hours.

“Routinely deployed rapid syndromic testing could complement or replace targeted components of the standard laboratory-based diagnostic repertoire for patients who are admitted to the hospital with an acute respiratory illness,” concluded authors of the study. Length of stay, readmittance, and death rates did not significantly differ between the two groups, and no serious adverse events were observed.

A PCR panel for CAP may improve pathogen detection, reduce unnecessary antibiotic use, shorten hospital length of stay, and potentially facilitate pathogen-directed treatment, though there is still limited evidence so far. The single-center design and early termination of the trial were major limitations, and future studies should examine the effect of comprehensive rapid syndromic testing on clinical outcomes, the authors said.

Editor’s note: To read MedPage Today’s coverage of this story, click here. To access the JAMA Network Open study, click here.