Short report: impact of selective reporting of antibiotic susceptibility testing on antibiotic use in patients with bloodstream infection with Enterococcus faecalis

Infection. 2023 Oct;51(5):1557-1562. doi: 10.1007/s15010-023-02045-4. Epub 2023 May 23.

Abstract

Introduction: Bloodstream infections with Enterococcus faecalis are associated with relevant morbidity and mortality. Targeted antimicrobial therapy is essential. The choice of an adequate treatment may be challenging when susceptibility testing offers different options. Selective reporting of antibiotic susceptibility test results might lead to a more tailored antibiotic therapy and could therefore be an important antimicrobial stewardship program intervention. The aim of this study was to analyse whether the introduction of selective reporting of antibiotic test results leads to a more targeted antibiotic therapy in patients with bloodstream infection with Enterococcus faecalis.

Methods: This study was performed as a retrospective cohort study at the University Hospital Regensburg, Germany. All patients with blood cultures positive for Enterococcus faecalis between March 2003 and March 2022 were analysed. In February 2014 selective reporting of antibiotic susceptibility test results omitting sensitivity results for agents not recommended was introduced.

Results: 263 patients with blood cultures positive for Enterococcus faecalis were included. After introduction of selective reporting of antibiotic tests (AI) significantly more patients received ampicillin than before introduction of selective reporting (BI) (9.6% BI vs. 34.6% AI, p < 0.001).

Conclusion: Selective reporting of antibiotic susceptibility test results led to a significantly higher use of ampicillin.

Keywords: Antimicrobial stewardship; Bloodstream infection; Enterococcus faecalis; Infectious endocarditis.

MeSH terms

  • Ampicillin
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Enterococcus faecalis
  • Enterococcus faecium*
  • Gram-Positive Bacterial Infections* / diagnosis
  • Gram-Positive Bacterial Infections* / drug therapy
  • Humans
  • Microbial Sensitivity Tests
  • Retrospective Studies
  • Sepsis*

Substances

  • Anti-Bacterial Agents
  • Ampicillin