دورية أكاديمية
Impact of Gram-Negative Rod Bacteremia Rapid Diagnostic Testing and Real-Time Clinical Pharmacist Intervention.
| العنوان: | Impact of Gram-Negative Rod Bacteremia Rapid Diagnostic Testing and Real-Time Clinical Pharmacist Intervention. |
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| المؤلفون: | Kremer AM; Department of Pharmacy, WakeMed Health and Hospitals, Raleigh, NC, USA., Bouchard JL; Department of Pharmacy, WakeMed Health and Hospitals, Raleigh, NC, USA.; University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA., Orvin AI; Department of Pharmacy, WakeMed Health and Hospitals, Raleigh, NC, USA.; University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA. |
| المصدر: | Journal of pharmacy practice [J Pharm Pract] 2024 Aug; Vol. 37 (4), pp. 940-944. Date of Electronic Publication: 2023 Oct 20. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Publications Country of Publication: United States NLM ID: 8900945 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-1937 (Electronic) Linking ISSN: 08971900 NLM ISO Abbreviation: J Pharm Pract Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2002-> : Thousand Oaks, Calif. : Sage Publications Original Publication: [Philadelphia, PA] : W.B. Saunders, [1988]- |
| مواضيع طبية MeSH: | Bacteremia*/diagnosis , Bacteremia*/drug therapy , Bacteremia*/microbiology , Pharmacists*/organization & administration , Anti-Bacterial Agents*/therapeutic use , Gram-Negative Bacterial Infections*/diagnosis , Gram-Negative Bacterial Infections*/drug therapy , Gram-Negative Bacterial Infections*/microbiology, Humans ; Retrospective Studies ; Male ; Female ; Aged ; Middle Aged ; Cohort Studies ; Pharmacy Service, Hospital/organization & administration ; Gram-Negative Bacteria/isolation & purification ; Gram-Negative Bacteria/drug effects ; Aged, 80 and over ; Diagnostic Tests, Routine/methods ; Time Factors |
| مستخلص: | Background: The optimal method for implementing rapid diagnostic testing (RDT) into clinical practice has not been determined for gram-negative rod (GNR) bacteremia. At our institution, RDT was implemented in conjunction with real-time notification of results to decentralized clinical pharmacists. Objective: To determine the impact of RDT result notification plus real-time clinical pharmacist review on the management of GNR bacteremia. Methods: This retrospective, matched cohort study included patients with a positive blood culture for a GNR on the BIOFIRE® Blood Culture Identification 2 panel from September 2020 to August 2021 (historical) and October 2021 to September 2022 (interventional). Exclusion criteria were polymicrobial bacteremia, discrepant RDT results from traditional culture, 24-hour mortality, and comfort care or not admitted at the time of RDT result. Patients were matched based on age, pathogen, and resistance. The primary endpoint was time from Gram stain to appropriate antibiotic therapy. Results: This study consisted of 240 patients (n = 120 historical, n = 120 interventional). Escherichia coli was isolated in 71% of patients with extended-spectrum beta-lactamase-producing organisms isolated in 8%. There was no difference in median time to appropriate therapy (0 vs 0 hours, P = 0.28). There was a statistically significant decrease in time to first organism-directed change in therapy (40 vs 11 hours; P < 0.01). Length of stay, days of anti-pseudomonal therapy, and inpatient mortality did not differ between groups. Conclusion: Implementation of RDT plus real-time clinical pharmacist review did not significantly decrease time to appropriate therapy in patients with GNR bacteremia but significantly reduced time to organism-directed antibiotic changes. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| فهرسة مساهمة: | Keywords: gram-negative rod bacteremia; infectious disease; rapid diagnostic test |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) |
| تواريخ الأحداث: | Date Created: 20231021 Date Completed: 20240729 Latest Revision: 20240729 |
| رمز التحديث: | 20240729 |
| DOI: | 10.1177/08971900231200900 |
| PMID: | 37864345 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1531-1937 |
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| DOI: | 10.1177/08971900231200900 |