Novel meningitis/encephalitis CSF testing shortens antiviral prescribing duration

The duration of antiviral prescribing has become much shorter with the introduction of the Biofire Filmarray meningitis/encephalitis (M/E) panel, a study has shown. However, its influence on antibiotic prescribing or health services in a paediatric hospital is minimal.

A team of investigators implemented the BioFire Filmarray M/E panel in March 2021 at their paediatric hospital laboratory as an additional routine test for all cerebrospinal fluid (CSF) samples obtained from infants aged <90 days or from patients in the emergency department.

The investigators performed a retrospective chart review to determine the changes in clinical outcomes, antimicrobial prescribing practices, and hospital length of stay. They compared two discrete 6-month periods: preimplementation (March‒August 2019) and postimplementation (March‒August 2021).

At baseline, both pre- and postimplementation groups were comparable, apart from a higher proportion of infants with enterovirus and parechovirus meningitis in the preimplementation group.

No significant between-group differences in terms of median length of stay (2.94 vs 3.47 days; p=0.41), duration of antibiotic treatment (2.0 vs 2.3 days; p=0.25), need for central venous access (12.9 percent vs 17 percent; p=0.38), or hospital-in-the-home admission (9.4 percent vs 9 percent; p=0.92).

The number of infants treated with acyclovir were similar between groups (33 percent vs 31 percent), but a decrease in duration during the postimplementation period was noted (1.36 vs 0.90 days; p=0.03).

“The introduction of new laboratory testing needs to be supported by a comprehensive stewardship program to see optimal outcomes from new testing platforms,” the investigators said.