Impact of phenotypic rapid diagnostic assay on duration of empiric antibiotics for gram-negative bacteremia. Issue 1 (30th January 2023)

• Record Type: Journal Article
• Authors: Mohayya, Sana M.; Arsalan, Mohammad; Narayanan, Navaneeth; Patel, Purvi; Hong, Christin G.; Kirn, Thomas J.; Bhatt, Pinki J.; Bhowmick, Tanaya
• Is Part Of: Antimicrobial stewardship & healthcare epidemiology. Volume 3:Issue 1(2023)
• Publication Date: 2023-01-30
• Subjects: Anti-infective agents -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Epidemiology -- Periodicals; 614.44
• DOI: 10.1017/ash.2022.331
• Languages: English
• ISSNs: 2732-494X

Abstract

Abstract: Objective: Rapid diagnostic tests (RDTs) are increasingly being implemented as antimicrobial stewardship tools to facilitate antibiotic modification and reduce complications related to their overutilization. We measured the clinical impact of a phenotypic RDT with antimicrobial stewardship (AMS) in the setting of gram-negative bacteremia. Setting and participants: In this single-center retrospective cohort study, we evaluated adult patients with gram-negative bacteremia who received at least 72 hours of an antibiotic. Methods: The primary outcome was the duration of empiric antibiotic therapy for gram-negative bacteremia. Secondary outcomes included time-to-directed therapy, proportion of modifications, hospital length of stay (LOS), and subsequent infection with a multidrug-resistant organism (MDRO) or C. difficile infection (CDI). Results: The duration of empiric antibiotics decreased in the RDT+AMS group (4 days vs 2 days; P < .01). Time to directed therapy decreased from 75.0 to 27.9 hours ( P < .01). Conclusions: The clinical outcomes of LOS, MDRO, and CDI were reduced. The phenotypic RDT demonstrated an improvement in stewardship measures and clinical outcomes.