Multiplex molecular respiratory diagnostic panels and antimicrobial use in paediatric respiratory infections: a systematic review and meta-analysis protocol
Year: 2026
Type: review
Study design: Study Protocol
Abstract: Introduction Multiplex syndromic molecular diagnostic panels enable rapid, simultaneous detection of multiple respiratory pathogens and are increasingly used in paediatric care. Although these assays improve pathogen identification and turnaround time, their impact on downstream antimicrobial stewardship and clinical outcomes remains uncertain. Existing evidence has largely focused on diagnostic accuracy rather than clinically actionable outcomes such as antimicrobial prescribing. Furthermore, prior reviews combine adult and paediatric populations, limiting the ability to draw conclusions relevant to paediatric antimicrobial stewardship. This systematic review and meta-analysis aims to evaluate the comparative effectiveness of multiplex molecular respiratory panels versus conventional diagnostic approaches on antimicrobial use and related outcomes in paediatric infections. Methods and analysis We will systematically search PubMed, Embase, Cochrane Library, Web of Science and Scopus, as well as trial registries and grey literature, without date restrictions. We will include randomised controlled trials and quasiexperimental studies (including controlled before-after and stepped-wedge designs) evaluating multiplex molecular respiratory panels in children (<18 years) with suspected or confirmed respiratory infections. Comparators include conventional diagnostics or usual care. Primary outcomes are antibiotic and antiviral use following diagnostic testing. Secondary outcomes include antimicrobial stewardship measures (eg, treatment modification, de-escalation, duration of therapy), clinical outcomes (eg, length of stay, mortality, readmission) and process outcomes (eg, turnaround time, time to targeted therapy). Risk of bias will be assessed using Cochrane Risk of Bias 2 and Risk of Bias in Non-randomized Studies–of Interventions tools. Where appropriate, data will be synthesised using random-effects meta-analysis, with separate analyses by study design. Heterogeneity will be explored through subgroup analyses and meta-regression. Narrative synthesis will be undertaken where pooling is not feasible. Certainty of evidence will be evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results will be presented as pooled effect estimates with 95% CIs where appropriate, or narrative synthesis where pooling is not feasible, in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, with the completed review to follow PRISMA 2020 guidelines. Ethics and dissemination Ethics approval is not required as this study uses secondary published data. Findings will be disseminated through peer-reviewed publication and conferences. PROSPERO registration number CRD420261283123. This review was registered prospectively; the review start date is 15 March 2026 and the anticipated end date is 19 October 2026. At initial submission the pilot screening was in progress.
Source: BMJ Open
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W7222089938