Influence of automated screening and confirmation of extended-spectrum beta-lactamase-producing members of the Enterobacteriaceae on prescribing of antibiotics

Journal of Medical Microbiology
Anthony M NicasioDavid P Nicolau

Abstract

This study investigated the clinician response to the extended-spectrum beta-lactamase (ESBL) confirmation report generated by an automated detection system, MicroScan Walkaway. The study compared two cohorts (pre- and post-automated detection) of patients with an ESBL-producing Escherichia coli or Klebsiella species non-urinary infection over the period October 2001-December 2006. Acceptance of the report, as defined by the initiation of carbapenem therapy, was observed in 69.2% of the post-automated detection cohort (n=78) versus 20% in the pre-automated detection period (n=15) (P<or=0.001). The utilization of a carbapenem increased progressively over the course of the study. Moreover, the time to initiation of carbapenem therapy was reduced from 15.7+/-4.9 to 0.1+/-2.0 days (P<or=0.001) after implementation of this automated detection system. Overall, clinicians responded positively to the ESBL automated detection report, as gauged by the increased utilization of a carbapenem and the earlier initiation of appropriate therapy; however, reductions in length of stay and mortality were not observed in this infected population.

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Citations

Mar 31, 2009·American Journal of Epidemiology·Laurence S LimTien Yin Wong

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