Ideal and Actual Impact of Rapid Diagnostic Testing and Antibiotic Stewardship on Antibiotic Prescribing and Clinical Outcomes in Children With Positive Blood Cultures

The Pediatric Infectious Disease Journal
Caroline H ReuterSameer J Patel

Abstract

Implementing matrix-assisted laser desorption ionization-time of flight and multiplex polymerase chain reaction has been associated with decreased mortality and hospital length of stay in adults, but the impact in pediatrics is less understood. This pre-post quasi-experimental study compared antibiotic prescribing for positive blood cultures in patients ≤21 years of age collected in 2012 (preintervention) and in 2015 (after matrix-assisted laser desorption ionization-time of flight/multiplex polymerase chain reaction). Time to effective and optimal antimicrobial therapy was evaluated using Cox proportional hazards regression. Time to ideal optimal therapy was estimated as the earliest potential initiation of optimal therapy. Antibiotic use and clinical outcomes were measured. There were 242 and 192 positive monomicrobial blood cultures in 2012 and 2015, respectively. Postintervention, time to optimal therapy (73.8 vs. 48.8 hours; P < 0.001) and organism identification (55.6 vs. 29.5 hours; P < 0.001) were reduced, and patients were more likely to receive optimal therapy by 7 days (hazard ratio, 1.85; P < 0.001). In the ideal scenario in 2015, there was an 8.8-hour delay in initiating optimal therapy based on the time that suffi...Continue Reading

References

Jul 12, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Carlos BantarMaría Eugenia Oliva
Aug 12, 2004·Pharmacotherapy·Robert C OwensUNKNOWN Society of Infectious Diseases Pharmacists
Oct 31, 2006·The American Journal of Medicine·Abigail FraserUNKNOWN TREAT Study Group
Aug 25, 2010·Antimicrobial Agents and Chemotherapy·Mical PaulLeonard Leibovici
Dec 25, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Olivier ClercGilbert Greub
Aug 1, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Angela M HuangJerod L Nagel
Sep 3, 2013·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·O ClercG Greub
Sep 28, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Karri A BauerDebra A Goff
Jul 23, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ritu BanerjeeRobin Patel
Jan 26, 2016·The Pediatric Infectious Disease Journal·Stephen T J RayAndrew Riordan

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Citations

Oct 31, 2019·Expert Review of Anti-infective Therapy·Chiara TersigniLuisa Galli
Jun 24, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Alison C TribbleEbbing Lautenbach
Aug 2, 2018·Irish Journal of Medical Science·Rosie Mc ColganJames A Sproule
Aug 18, 2020·Pediatric Health, Medicine and Therapeutics·J Michael Klatte

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