Enhanced Detection of Lower Respiratory Pathogens in Adults and Pediatrics Using the BioFire FilmArray Pneumonia Plus Panel

Background Lower respiratory tract infections (LRTIs) are a major global health burden, and rapid identification of causative pathogens is crucial for selecting appropriate antimicrobial therapy. Conventional culture requires 24–72 hours and often fails to detect fastidious organisms, viral pathogens, or organisms suppressed by prior antibiotics. The BioFire FilmArray Pneumonia Plus Panel (BFPP) is a rapid multiplex PCR assay that identifies a broad range of bacterial, viral, and antimicrobial resistance targets in about 75 minutes. Methods This narrative review compiles findings from published analytical and clinical studies assessing BFPP performance in adult and pediatric LRTIs. Searches were conducted in PubMed, Google Scholar, and ScienceDirect, excluding unrelated articles. Comparative evaluations with standard culture and other molecular assays focused on detection rates, sensitivity, specificity, turnaround time, and effects on antimicrobial management. Data from a single-center evaluation were also included to illustrate real-world application. Results Across studies, BFPP and similar multiplex PCR platforms significantly increased pathogen detection compared with culture, reporting identification rates of 40–66% versus 20–53% for culture. Gains were greatest for fastidious bacteria and viral co-infections. Sensitivity ranged from 57% to >90%, with specificity generally above 90%. When culture-negative but mPCR-positive results in pre-treated patients were considered true infections, sensitivity approached 98%. BFPP’s detection of ~33 respiratory pathogens and key resistance markers in 75 minutes supports earlier targeted therapy and reduced empirical broad-spectrum use. Conclusion BFPP provides rapid, broad, and clinically meaningful pathogen detection in LRTIs, improving diagnostic accuracy and supporting antimicrobial stewardship when integrated with clinical assessment.