The impact of rapid diagnostic testing, surveillance software, and clinical pharmacist staffing at a large community hospital in the management of Gram-negative bloodstream infections
| Autor: | Grace C. Lee, C. B. Jackson, Richard J. Fetchick, Edward Septimus, Brenda Astorga, Gerard W. Gawrys, Khine Tun |
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| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) medicine.medical_specialty Time Factors education 030106 microbiology Staffing Pharmacist Bacteremia Hospitals Community Pharmacy Pharmacists Antimicrobial Stewardship 03 medical and health sciences 0302 clinical medicine Anti-Infective Agents Drug Resistance Multiple Bacterial Gram-negative bacteremia Humans Medicine Antimicrobial stewardship Public Health Surveillance 030212 general & internal medicine Diagnostic Techniques and Procedures Aged Retrospective Studies Aged 80 and over Inpatients business.industry Diagnostic test General Medicine Middle Aged Community hospital Clinical pharmacy Infectious Diseases Emergency medicine Workforce Female Gram-Negative Bacterial Infections business Software |
| Zdroj: | Diagnostic Microbiology and Infectious Disease. 98:115084 |
| ISSN: | 0732-8893 |
| DOI: | 10.1016/j.diagmicrobio.2020.115084 |
| Popis: | Rapid diagnostic testing (RDT) combined with an antimicrobial stewardship program (ASP) has shown improved outcomes in bloodstream infections (BSIs). We assessed the impact of RDT, surveillance software, and ASP pharmacist staffing on time to optimal therapy (TOT) in Gram-negative BSIs. Adults with Gram-negative BSIs were included in this retrospective evaluation across 2 study periods. The preimplementation group (n = 121) had longer TOT than the postimplementation group (n = 120) (59.6 ± 36.2 h versus 29.0 ± 24.2 h, P 0.001). Escalation (51.1 ± 26.4 h versus 16.9 ± 15.7 h, P 0.001) and de-escalation (63.1 ± 39.5 h versus 39.2 ± 25.6 h, P 0.01) of therapy were shorter in the postimplementation group. TOT for patients with multidrug-resistant organisms (MDROs) was shorter in the postimplementation group (61.8 ± 37.2 h versus 21.9 ± 18.8 h, P 0.001). TOT was shorter during fully staffed clinical pharmacist hours (30.6 ± 58.9 h versus 19.7 ± 31.7 h, p = 0.014). Implementation of RDT and surveillance software with an ASP decreased TOT for Gram-negative BSIs, including MDROs. |
| Databáze: | OpenAIRE |
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