The impact of a multidisciplinary antimicrobial stewardship team on the timeliness of antimicrobial therapy in patients with positive blood cultures: a randomized controlled trial
| العنوان: | The impact of a multidisciplinary antimicrobial stewardship team on the timeliness of antimicrobial therapy in patients with positive blood cultures: a randomized controlled trial |
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| المؤلفون: | Peter G. Kelley, Michelle K Yong, Michael J. Dooley, Allen C. Cheng, Kelly A. Cairns, Kylie Horne, Joseph Doyle, Nicole Bushett, Janine M Trevillyan, Rhonda L. Stuart |
| المصدر: | Journal of Antimicrobial Chemotherapy. 71:3276-3283 |
| بيانات النشر: | Oxford University Press (OUP), 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Time Factors, 030106 microbiology, MEDLINE, law.invention, 03 medical and health sciences, 0302 clinical medicine, Anti-Infective Agents, Randomized controlled trial, law, Sepsis, Internal medicine, Acute care, medicine, Humans, Antimicrobial stewardship, Pharmacology (medical), Blood culture, Prospective Studies, 030212 general & internal medicine, Intensive care medicine, Prospective cohort study, Aged, Aged, 80 and over, Pharmacology, medicine.diagnostic_test, business.industry, Australia, Middle Aged, Antimicrobial, Drug Utilization, Hospitals, Clinical trial, Infectious Diseases, Blood Culture, Female, business |
| الوصف: | Background Antimicrobial stewardship teams play an important role in assisting with the optimization of antimicrobial use in acute care settings. We aimed to determine whether a rapid review by a multidisciplinary antimicrobial stewardship team would improve the timeliness of optimal antimicrobial therapy for patients with positive blood cultures. Methods This prospective randomized controlled trial was undertaken in two Australian hospitals. Patients received either standard care (a clinical microbiologist, registrar or laboratory scientist communicating the positive blood culture by phone to the treating doctor) or intervention (standard care plus rapid review by a multidisciplinary antimicrobial stewardship team). Outcomes included time to appropriate and/or active antimicrobial therapy and in-hospital mortality. The trial was registered on the Australian New Zealand Clinical Trials Registry (ACTRN12614000258651). Results A total of 160 patients were enrolled in this study: 81 in the standard care arm and 79 in the intervention arm. Patients in the intervention arm were commenced earlier on active (HR 8.02, 95% CI: 2.15-29.91) and appropriate antimicrobials (HR 1.95, 95% CI: 1.13-3.38), with a higher proportion of patients allocated to the intervention arm receiving active therapy at 48 h (96% versus 82%) and appropriate therapy at 72 h (70% versus 54%). The majority of patients where the blood culture was a contaminant were not started on antimicrobial therapy, and there were no significant differences in time to cessation of antimicrobial therapy. Conclusions Antimicrobial stewardship team review of patients with pathogenic positive blood cultures improved the time to both active and appropriate antimicrobial therapy. |
| تدمد: | 1460-2091 0305-7453 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::07899a3b30b2605503b8914be5b77484 https://doi.org/10.1093/jac/dkw285 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....07899a3b30b2605503b8914be5b77484 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14602091 03057453 |
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