Implementation of Rapid Molecular Infectious Disease Diagnostics: the Role of Diagnostic and Antimicrobial Stewardship

Messacar, Kevin; Parker, Sarah K.; Todd, James K.; Dominguez, Samuel R.

doi:10.1128/jcm.02264-16

Cited by 250 publications

(184 citation statements)

References 30 publications

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“…The use of procalcitonin‐guided treatment in patients with sepsis has resulted in shorter antibiotic duration with no difference in mortality . Rapid diagnostic technologies provide antimicrobial stewardship programs the opportunity to offer prompt decision support . With the availability of viral rapid diagnostic tests, there is the potential to decrease unnecessary antibiotic use or avoid starting antibiotics altogether.…”

Section: Resultsmentioning

confidence: 99%

Shortened Courses of Antibiotics for Bacterial Infections: A Systematic Review of Randomized Controlled Trials

Hanretty

Gallagher

2018

Pharmacotherapy

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Commonly prescribed durations of therapy for many, if not most, bacterial infections are not evidence-based. Misunderstandings by clinicians and patients alike influence perspectives on antibiotic use, including duration of therapy and its role in antibiotic resistance. To demonstrate that shorter durations of antibiotic therapy are as efficacious as longer durations for many infections, a systematic review was undertaken of English-language articles by using PubMed to identify articles for inclusion. Additionally, infection-specific guidelines were identified for review of recommendations. Search terms included specific infection types, randomized controlled trial (RCT), duration of therapy, treatment duration, short course, and long course. Only RCTs of single-agent antibiotic therapy for the treatment of bacterial infections in adults were included. Independent data extraction of articles was conducted by two authors by using predefined guidance for article inclusion. In total, 23 RCTs met our criteria for inclusion. All trials compared single-agent antibiotics for a short and long antibiotic course in six common infections: community-acquired pneumonia, ventilator-associated pneumonia, intraabdominal infections, skin and soft tissue infections, uncomplicated cystitis, and complicated cystitis or pyelonephritis. Clinicians can decrease net antibiotic use by recommending shorter courses where evidence supports them. Antimicrobial stewardship programs that systematically address treatment duration may significantly affect institutional antibiotic use without negatively affecting patient care.

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Section: Resultsmentioning

confidence: 99%

Shortened Courses of Antibiotics for Bacterial Infections: A Systematic Review of Randomized Controlled Trials

Hanretty

Gallagher

2018

Pharmacotherapy

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“…4 Antimicrobial stewardship programs (ASPs) can help achieve these outcomes by acting as active messengers and educators for medical teams. 4,5 The purpose of this study was to assess the impact of real-time pharmacy intervention on antibiotic deescalation based on DRP results.…”

Section: Rapid Respiratory Panel Testing: Impact Of Active Antimicrobmentioning

confidence: 99%

“…[2][3][4] One strategy to address these negative perceptions is the PPE Free Zone, a taped-off box measuring 3 £ 3 feet placed in the threshold of a patient's doorway. 5 However, patient perceptions of CPs, in general, remain underexplored.…”

Section: Exploring Patient Perceptions Of Contact Precautionsmentioning

confidence: 99%

Rapid respiratory panel testing: Impact of active antimicrobial stewardship

Abbas

Bernard²,

Lee³

et al. 2019

American Journal of Infection Control

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Table 1 ASP recommendations and team actions ASP recommendation, n (%) No change: 28 (41.2) Discontinue antibiotics: 16 (23.5) Decrease duration of antibiotics: 14 (20.6) Infectious Diseases consult: 5 (7.4) Deescalate therapy: 6 (8.8) Escalate therapy: 0 (0.0) Accepted recommendation, n (%) Yes: 45 (66.2) No: 23 (33.8) Action following ASP recommendation, n (%) No change: 40 (58.8) Discontinue antibiotics: 6 (8.8) Decrease duration of antibiotics: 9 (13.2) Infectious Diseases consult: 2 (2.9) Deescalate therapy: 7 (10.3) Escalate therapy: 4 (5.9) Time from test result to antibiotic change, h, mean (range) 13.5 (0.5-40) ASP, antimicrobial stewardship program.

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“…In other words, diagnostic testing is needed to establish the presence or absence of infection. (6) While the term diagnostic stewardship is relatively new, the term is antibiotic stewardship is already in place for a while. The idea of antibiotic stewardship is to have coherent actions which promote using antimicrobials responsibly.…”

Section: Imminent Threat Of Antibiotic Resistance and The Importancementioning

confidence: 99%

Imminent threat of antibiotic resistance and the importance of diagnostic and antibiotic stewardship

Yusuf

2017

Universa Medicina

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Antibiotic is one of the hallmarks of modern medicine. Antibiotics have saved many lives that was unthinkable prior to the discovery of antibiotic. Yet, antibiotic use is associated with the danger of resistance of bacteria. Resistance of bacteria to antibiotics means simply that antibiotics cannot be used to treat infection, that a simple skin and soft tissue infection may lead to death. Already in 1945, when Alexander Flemming received his Nobel Prize in 1945 for his part in the discovery of penicillin, he delivered a speech where he warned about this danger 1. In his speech, he mentioned the problem of underdosage of antibiotics. As the time passed by, we know that the problem is not only related to underdosage but also to other aspects of inappropriate use of antibiotics such as unnecessary use (for example when the infection is due to a virus), and extended duration of antibiotics 2.

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Implementation of Rapid Molecular Infectious Disease Diagnostics: the Role of Diagnostic and Antimicrobial Stewardship

Cited by 250 publications

References 30 publications

Shortened Courses of Antibiotics for Bacterial Infections: A Systematic Review of Randomized Controlled Trials

Shortened Courses of Antibiotics for Bacterial Infections: A Systematic Review of Randomized Controlled Trials

Rapid respiratory panel testing: Impact of active antimicrobial stewardship

Imminent threat of antibiotic resistance and the importance of diagnostic and antibiotic stewardship

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