Evidence of Clinical Impact Supports a New Petition for Medicare Coverage of 2-[18F]Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography/Computed Tomography in the Evaluation of Staphylococcus aureus Bacteremia: A Focused Literature Review and Call to Action . (10th May 2022)

• Record Type: Journal Article
• Authors: Thottacherry, Elizabeth; Cortés-Penfield, Nicolás W
• Is Part Of: Clinical infectious diseases. Volume 75:Number 8(2022)
• Page Start: 1457
• Page End: 1461
• Publication Date: 2022-05-10
• Subjects: Staphylococcus aureus -- bacteremia -- bloodstream infection -- 18F-FDG-PET -- PET/CT; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac363
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Staphylococcus aureus bacteremia (SAB) causes considerable morbidity and mortality and requires comprehensive assessment for metastatic infection. The roles of routine imaging beyond echocardiography in SAB, including 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT), remain contentious. We performed a literature review of studies reporting impact of 18F-FDG-PET/CT on the clinical management or outcomes of SAB published through 1 March 2022. We identified 7 observational studies in which 18F-FDG-PET/CT frequently identified metastatic foci of infection, revealed foci undetected by prior investigations, led to additional source control procedures, and was associated with fewer infection relapses and lower mortality. Calculated numbers needed to treat for receipt of 18F-FDG-PET/CT were 7–9 to change antimicrobial therapy, 10–27 to lead to an additional source control procedure, and 4–8 to prevent death. These data are comparable to the evidence for clinical impact of other diagnostic modalities accepted as standard of care in SAB, and form a compelling basis for advocacy to expand access to 18F-FDG-PET/CT. Abstract : Evidence suggests 18F-FDG-PET/CT frequently changes the clinical management of Staphylococcus aureus bacteremia (SAB) and leads to improved patient outcomes, similar to other widely accepted studies. ID clinicians should advocate for payer coverage and expanded access to 2- [18F] Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography/Computed Tomography for SAB evaluation.