FilmArray and procalcitonin as diagnostic tools in the management of pediatric patients with respiratory infections in the ICU

Abstract

Background: Acute respiratory infections (ARIs) are a leading cause of morbidiity and mortality in children under five years of age. A high rate of inappropriate antimicrobial prescription for viral infections contributes to increased bacterial resistance and higher medical costs. Aim: To evaluate the usefulness of the respiratory FilmArray™ and procalcitonin (PCT) in prescription of antibiotics. Methodology: Retrospective observational study of 50 pediatric patients with severe ARIs, conducted in the PICU in the Hospital Universitario Fundación Santa Fe de Bogotá, between 2017 and 2020. Patients aged 1 month to 17 years with FiO₂ requirements >50% or requiring high-flow systems were included. Demographic data, diagnostic test results, and therapeutic decisions were analyzed using descriptive statistics. Results: 80% of patients had positive FilmArray™ results, with rhinovirus/enterovirus being the most common pathogen. Antibiotic therapy was suspended in 22% of the cases, mainly in patients with PCT <0.5 ng/dL and positive results for viral etiology. Conclusion: The combination of the FilmArray™ and PCT improved antimicrobial prescribing, reducing unnecessary antimicrobial use without compromising patient safety. These findings highlight the importance of incorporating combined diagnostic tools into clinical practice for pediatric patients with severe ARI. Rapid and specific tests are essential for guiding the management of ARIs in children.