Impact of Reporting Gram Stain Results From Blood Cultures on the Selection of Antimicrobial Agents
| Autor: | John C.H. Steele, Rebecca B Stone |
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| Rok vydání: | 2009 |
| Předmět: | |
| Zdroj: | American Journal of Clinical Pathology. 132:5-6 |
| ISSN: | 1943-7722 0002-9173 |
| DOI: | 10.1309/ajcp9ruv0yglbvha |
| Popis: | The reporting of Gram stain results from positive blood culture bottles clearly impacts the early selection of proper antimicrobial treatment. Mackenzie et al1 recognized that bacteremia is associated with serious morbidity and mortality, especially in certain groups of patients. Despite the broad range of antimicrobial agents available, a delay in inappropriate antibiotic administration can result in “progressive deterioration and the development of intractable complications.”2 Criteria for determining the appropriate antibiotic treatment for the specific clinical situation must include spectrum of activity, achievable blood levels, toxic effects, dosing and duration of therapy, and cost-effectiveness.3 Clinicians often face difficult therapy decisions that must be made well before a definitive identification of the pathogen causing the bacteremia is determined. Blood cultures in conjunction with the initial Gram stain of positive cultures have often been considered the “gold standard” for the diagnosis of bacteremia.4 The Gram stain, developed in 1884 by Hans Christian Gram, is one of the most important and most useful laboratory tests used in the clinical microbiology setting.5 Physicians continue to rely on the Gram stain result during the first 24 to 48 hours for the selection of appropriate antibiotic treatment for patients with positive blood cultures because susceptibility results usually cannot be provided in less than 48 to 72 hours. Gram-negative sepsis results in death 50% of the time during the first 2 days of the illness, demonstrating the importance of immediate and appropriate treatment.6 To be useful in guiding … |
| Databáze: | OpenAIRE |
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