466: EVALUATION OF ANTIMICROBIAL STEWARDSHIP WITH THE BIOFIRE FILMARRAY PNEUMONIA PANEL IN THE TRAUMA ICU

Introduction: On August 26th 2019, Charleston Area Medical Center (CAMC) implemented a new diagnostic tool for pneumonia, the BioFire Pneumonia Panel (PCR). This new technology is to help identify pathogens rapidly and allow for more direct antibiotic management or de-escalation in the case of viral culprits and negative tests. Pneumonia PCR has been extensively studied in use with samples collected from bronchial alveolar lavage (BAL). At CAMC, it was made available for all samples from the airway; BAL, aspirate, and sputum samples. Methods: This is a retrospective case-control observational study of patients admitted between September 1, 2017 – August 26, 2019 and August 27, 2019 – August 31, 2021 who were treated for pneumonia in the Surgical/Trauma Intensive Care Unit (STICU) at CAMC. The primary objective of this study is to determine if the use of the BioFire Pneumonia Panel has lead to positive impacts on antimicrobial stewardship as defined by appropriate or inappropriate antibiotic continuation, discontinuation, escalation, or de-escalation. Secondary outcomes evaluated were time to change in antibiotic therapy, and Clostridioides difficile rates. Results: A total of 150 patients were evaluated with 103 patients in the pre-BioFire group and 47 patients in the post-BioFire group. No statistical difference was seen between appropriate continuation, discontinuation, and de-escalation, however, there was a statistically significant difference in appropriate escalation with 6 (5.8%) in the pre-BioFire group vs 10 (21.3%) in the post-BioFire group (p-value = 0.04). No difference was noted in the inappropriate groups. No difference in mean time to antibiotic change was seen, except appropriate escalation with 27.44 ± 3.00 hours pre-BioFire vs 10.81 ± 7.54 hours post-BioFire (p-value < 0.001). Rates of C. difficile rates were similar between groups with 2.7% vs 2.64% respectively. Conclusions: Our study showed no difference on antimicrobial stewardship with the exception of a statistically significant increase in appropriate escalation of antibiotic therapy. Based on similar timing of change in antibiotic therapy, our results suggest further education and knowledge on the utility and time of reported PCR data is required.