# Impact of FilmArray Gastrointestinal Panel Compared to Standard-of-Care Diagnostic Tests in Clinical Practice of Acute Gastroenteritis in an HIV Reference Center with Limited Resources

## TL;DR

A new diagnostic test for gastroenteritis improves detection rates, reduces treatment time, and lowers costs in a resource-limited HIV center.

## Contribution

The study provides real-world evidence of the FilmArray gastrointestinal panel's effectiveness in a low-resource setting.

## Key findings

- The FilmArray panel increased pathogen detection rates to 64% compared to 32% with standard methods.
- The panel reduced diagnostic time by 18% and antimicrobial use by 30%.
- Antimicrobial costs were reduced by 83% using the FilmArray panel.

## Abstract

Background/Objectives: Gastroenteritis remains a major global health concern, particularly in resource-limited regions, where rapid and accurate diagnosis is crucial for effective patient management. Syndromic multiplex PCR panels, such as the FilmArray gastrointestinal (FAGI) panel, offer the potential to significantly improve diagnostic yield and turnaround time, enabling more targeted treatments and reducing unnecessary antibiotic use. However, real-world data on their performance in low-resource settings remains scarce. This study evaluates the performance, clinical impact, and cost-effectiveness of the FAGI panel compared to standard of care (SOC) diagnostic methods in gastroenteritis cases at São José Hospital for Infectious Diseases in Fortaleza, Brazil, an HIV Reference Center, in a resource-limited region of a middle-income country. Methods: A retrospective observational study was conducted among patients tested with FAGI (n = 161) and a retrospective control group tested only with SOC methods (n = 166). Results: The FAGI panel was associated with a significant reduction in the turnaround time, antimicrobial use, and total treatment costs while increasing the pathogen detection rate. Specifically, the median diagnostic time was reduced by 18%, with an increase in pathogen detection compared to SOC methods (64% positivity compared to 32%). Moreover, the FAGI group experienced a 30% reduction in antibiotic use, with a corresponding 83% reduction in antimicrobial costs. Conclusions: These results suggest that the FilmArray panel may offer substantial benefits in terms of efficiency and cost savings, highlighting its potential for broader implementation in clinical practice, especially in resource-limited settings, to improve patient outcomes in infectious disease management.