期刊
EXPERT REVIEW OF MOLECULAR DIAGNOSTICS
卷 22, 期 1, 页码 49-60出版社
TAYLOR & FRANCIS AS
DOI: 10.1080/14737159.2022.2018302
关键词
NAATs; infectious respiratory disease; molecular diagnostics; CE-IVD tests; syndromic approach; syndromic panels; cap; hap; vap; fast microbiology
类别
The management of pneumonia patients involves challenges such as accurate microbiological investigations, prompt therapeutic management, and optimal treatment duration. Rapid diagnostic tests may be a feasible tool to optimize timing of targeted treatments, especially in terms of early de-escalation or discontinuation of antibiotic therapy.
Introduction Pneumonia is one of the main causes of mortality associated with infectious diseases worldwide. Several challenges have been identified in the management of patients with pneumonia, ranging from accurate and cost-effective microbiological investigations, prompt and adequate therapeutic management, and optimal treatment duration. Areas covered In this review, an updated summary on the current management of pneumonia patients is provided and the epidemiological issues of infectious respiratory diseases, which in the current pandemic situation are of particular concern, are addressed. The clinical and microbiological approaches to pneumonia diagnosis are reviewed, including discussion about the new molecular assays pointing out both their strengths and limitations. Finally, the current recommendations about antibiotic treatment are examined and discussed depending on the epidemiological contexts, including those with high prevalence of multidrug-resistant bacteria. Expert opinion We claim that rapid diagnostic tests, if well-positioned in the diagnostic workflow and reserved for the subset of patients who could most benefit from these technologies, may represent an interesting and feasible tool to optimize timing of targeted treatments especially in terms of early de-escalation or discontinuation of antibiotic therapy.
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