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

Sana M Mohayya; Mohammad Arsalan; Navaneeth Narayanan; Purvi Patel; Christin G Hong; Thomas J Kirn; Pinki J Bhatt; Tanaya Bhowmick

doi:10.1017/ash.2022.331

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

Antimicrob Steward Healthc Epidemiol. 2023 Jan 30;3(1):e22. doi: 10.1017/ash.2022.331. eCollection 2023.

Authors

Sana M Mohayya¹, Mohammad Arsalan², Navaneeth Narayanan^{1

2

3}, Purvi Patel², Christin G Hong², Thomas J Kirn^{1

2}, Pinki J Bhatt^{2

3}, Tanaya Bhowmick²

Affiliations

¹ Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
² Division of Allergy, Immunology, Infectious Diseases, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
³ Rutgers University Ernest Mario School of Pharmacy, Rutgers University, New Brunswick, NJ, USA.

Abstract

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 C. difficile infection (CDI).

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

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