Clinical Utility and Cost-Effectiveness of Molecular Diagnostic-Guided Antimicrobial Therapy in Sepsis: A Retrospective Cohort Study

This study aims to determine the clinical utility and cost-effectiveness of molecularly-guided antimicrobial therapy in sepsis. Sepsis is a leading cause of morbidity and mortality worldwide, with a high burden of disease and death reported in various contexts, and is recognized by the WHO as a public health priority, highlighting the need to improve its timely diagnosis and management. According to the Sepsis-3 consensus, sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, and early identification of the etiological agent and antimicrobial resistance mechanisms is essential for optimizing treatment. In this context, rapid molecular diagnostic tests, such as multiplex PCR, allow for the early detection of pathogens and resistance genes, reducing the time to appropriate therapy. Several studies have demonstrated that their implementation is associated with improved clinical outcomes and optimized antimicrobial use, in addition to being a cost-effective strategy, particularly when integrated with antimicrobial stewardship programs. These tools also contribute to the advancement of precision medicine in infectious diseases.
This was an observational and retrospective study conducted in a private level III-1 hospital in Lima, which included 200 patients who met the criteria for Sepsis-3, had been hospitalized for more than 48 hours, and presented positive results in blood cultures and molecular tests (2019-2023), excluding cases of COVID-19, bacteria of low clinical relevance, and contaminated samples.
The key words used were: Sepsis, Length of Stay, Mortality, Cost-Effectiveness Analysis. This study was approved by the Ethics Committee of the University of Tacna in Perú (Resolution FACSA-CEI/004-02-2025). The study was conducted in accordance with the principles of the Declaration of Helsinki.