Impact of phenotypic rapid diagnostic assay on duration of empiric antibiotics for gram-negative bacteremia.

OBJECTIVE

Rapid diagnostic tests (RDTs) are increasingly being implemented as antimicrobial stewardship tools to facilitate antibiotic modification and reduce complications related to their overutilization. We measured the clinical impact of a phenotypic RDT with antimicrobial stewardship (AMS) in the setting of gram-negative bacteremia.

SETTING AND PARTICIPANTS

In this single-center retrospective cohort study, we evaluated adult patients with gram-negative bacteremia who received at least 72 hours of an antibiotic.

METHODS

The primary outcome was the duration of empiric antibiotic therapy for gram-negative bacteremia. Secondary outcomes included time-to-directed therapy, proportion of modifications, hospital length of stay (LOS), and subsequent infection with a multidrug-resistant organism (MDRO) or (CDI).

RESULTS

The duration of empiric antibiotics decreased in the RDT+AMS group (4 days vs 2 days; < .01). Time to directed therapy decreased from 75.0 to 27.9 hours ( < .01).

CONCLUSIONS

The clinical outcomes of LOS, MDRO, and CDI were reduced. The phenotypic RDT demonstrated an improvement in stewardship measures and clinical outcomes.