Management of Gram-Negative Bloodstream Infections in the Era of Rapid Diagnostic Testing: Impact With and Without Antibiotic Stewardship
JournalOpen Forum Infectious Diseases
PublisherOxford University Press
MetadataShow full item record
AbstractEight-hundred thirty-two patients were included; 237 pre-RDT/AMS vs 308 post-RDT/pre-AMS vs 237 post-RDT/AMS, respectively. The proportion of patients on optimal antibiotic therapy increased with each intervention (66.5% vs 78.9% vs 83.2%; P < .0001). Time to optimal therapy (interquartile range) decreased with introduction of RDT: 47 (7.9-67.7) hours vs 24.9 (12.4-55.2) hours vs 26.5 (10.3-66.5) hours (P = .09). Using multivariable modeling, infectious diseases (ID) consult was an effect modifier. Within the ID consult stratum, controlling for source and ICU stay, compared with the pre-RDT/AMS group, both post-RDT/pre-AMS (adjusted hazard ratio [aHR], 1.34; 95% CI, 1.04-1.72) and post-RDT/AMS (aHR, 1.28; 95% CI, 1.01-1.64), improved time to optimal therapy. This effect was not seen in the stratum without ID consult.
Rights/Terms© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/14172