Impact of phenotypic rapid diagnostic assay on duration of empiric antibiotics for gram-negative bacteremia

Sana M. Mohayya; Mohammad Arsalan; Navaneeth Narayanan; Purvi Patel; Christin G. Hong; Thomas J. Kirn; Pinki J. Bhatt; Tanaya Bhowmick

doi:https://doi.org/10.1017/ash.2022.331

Impact of phenotypic rapid diagnostic assay on duration of empiric antibiotics for gram-negative bacteremia

Sana M. Mohayya, Mohammad Arsalan, Navaneeth Narayanan, Purvi Patel, Christin G. Hong, Thomas J. Kirn, Pinki J. Bhatt, Tanaya Bhowmick

Research output: Contribution to journal › Article › peer-review

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.

Original language	American English
Article number	e22
Journal	Antimicrobial Stewardship and Healthcare Epidemiology
Volume	3
Issue number	1
DOIs	https://doi.org/10.1017/ash.2022.331
State	Published - Jan 30 2023
Externally published	Yes

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases
Epidemiology

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title = "Impact of phenotypic rapid diagnostic assay on duration of empiric antibiotics for gram-negative bacteremia",

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.",

author = "Mohayya, {Sana M.} and Mohammad Arsalan and Navaneeth Narayanan and Purvi Patel and Hong, {Christin G.} and Kirn, {Thomas J.} and Bhatt, {Pinki J.} and Tanaya Bhowmick",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America.",

year = "2023",

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doi = "https://doi.org/10.1017/ash.2022.331",

language = "American English",

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T1 - Impact of phenotypic rapid diagnostic assay on duration of empiric antibiotics for gram-negative bacteremia

AU - Mohayya, Sana M.

AU - Arsalan, Mohammad

AU - Narayanan, Navaneeth

AU - Patel, Purvi

AU - Hong, Christin G.

AU - Kirn, Thomas J.

AU - Bhatt, Pinki J.

AU - Bhowmick, Tanaya

PY - 2023/1/30

Y1 - 2023/1/30

N2 - 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.

AB - 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.

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Impact of phenotypic rapid diagnostic assay on duration of empiric antibiotics for gram-negative bacteremia

Abstract

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