https://doi.org/10.4081/mm.2026.15721
The value of rapid diagnostics in pediatric care: a stewardship-based framework informed by a multidisciplinary meeting in Rome
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Published: 9 June 2026
Rapid syndromic diagnostics are increasingly used in pediatric acute care to provide early etiologic information and broaden pathogen detection. Their value, however, does not rely on speed alone. By simultaneously testing for multiple pathogens and, in selected settings, antimicrobial resistance determinants, these assays may help clinicians interpret complex infectious syndromes earlier than conventional or sequential strategies. This distinction between “rapid” and “syndromic” is particularly relevant in pediatrics, where clinical presentations are often non-specific and decisions on antibiotics, admission, isolation, escalation, or discharge are frequently made before conventional microbiology results are available.
Rapid results improve care only when embedded in clinical pathways that define patient selection, specimen collection, result interpretation, and consequent actions. This manuscript combines a pathway-oriented narrative synthesis with key messages from the multidisciplinary conference “The value of rapid diagnostics in child care,” recently held in Rome. Across emergency, inpatient, intensive care, infectious disease, microbiology, and health-system perspectives, a consistent message emerged: rapid syndromic diagnostics improve decision-making when broad, timely results are linked to predefined actions, including treatment initiation or discontinuation, escalation or de-escalation, isolation or de-isolation, disposition decisions, and confirmatory testing.
We translate these concepts across pediatric emergency department, ward, and intensive care settings, focusing on respiratory syndromes, suspected sepsis, severe pneumonia, and central nervous system infections. In these scenarios, rapid syndromic results may anticipate conventional microbiology and support earlier therapeutic optimization. Nevertheless, they should complement rather than replace culture-based confirmation and phenotypic antimicrobial susceptibility testing. Implementation requires governance, education, communication, and measurable indicators.
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CRediT authorship contribution
VC, PB, AV, and CFP contributed to the conceptualization of the manuscript, to the methodology and the implementation-oriented narrative synthesis, to the investigation and critical synthesis of the multidisciplinary perspectives discussed during the Rome meeting, to the review and editing of the manuscript, and prepared the original draft; VC, PB, and CFP performed the formal analysis and interpretation of the conference-derived themes and supporting literature; CFP supervised the work and was responsible for funding acquisition. All the authors have read and approved the final version of the manuscript and agreed to be held accountable for all aspects of the work.
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