Optimization of Empirical Antimicrobial Therapy in Enterobacterales Bloodstream Infection Using the Extended-Spectrum Beta-Lactamase Prediction Score

Clinical tools for the prediction of antimicrobial resistance have been derived and validated without examination of their implementation in clinical practice. This study examined the impact of utilization of the extended-spectrum beta-lactamase (ESBL) prediction score on the time to initiation of a...

Full description

Saved in:
Bibliographic Details
Published in:Antibiotics (Basel) 2023-06, Vol.12 (6), p.1003
Main Authors: Haimerl, Brian J, Encinas, Rodrigo, Justo, Julie Ann, Kohn, Joseph, Bookstaver, P Brandon, Winders, Hana Rac, Al-Hasan, Majdi N
Format: Article
Language:English
Subjects:
antibiotics
Antimicrobial agents
Antimicrobial resistance
bacteremia
Ceftriaxone
Clinical outcomes
Drug resistance
Enterobacterales
Escherichia coli
Gram-negative
Infections
Klebsiella species
Length of stay
Mortality
Optimization
Patients
Predictions
Reduction
sepsis
Teams
Therapy
β Lactamase
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Clinical tools for the prediction of antimicrobial resistance have been derived and validated without examination of their implementation in clinical practice. This study examined the impact of utilization of the extended-spectrum beta-lactamase (ESBL) prediction score on the time to initiation of appropriate antimicrobial therapy for bloodstream infection (BSI). The quasi-experimental cohort study included hospitalized adults with BSI due to ceftriaxone-resistant (CRO-R) at three community hospitals in Columbia, South Carolina, USA before (January 2010 to December 2013) and after (January 2014 to December 2019) implementation of an antimicrobial stewardship intervention. In total, 45 and 101 patients with BSI due to CRO-R were included before and after the intervention, respectively. Overall, the median age was 66 years, 85 (58%) were men, and 86 (59%) had a urinary source of infection. The mean time to appropriate antimicrobial therapy was 78 h before and 46 h after implementation of the antimicrobial stewardship intervention ( = 0.04). Application of the ESBL prediction score as part of an antimicrobial stewardship intervention was associated with a significant reduction in time to appropriate antimicrobial therapy in patients with BSI due to CRO-R . Utilization of advanced rapid diagnostics may be necessary for a further reduction in time to appropriate antimicrobial therapy in this population.
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics12061003