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Impact of Integrated Rapid Diagnostic Testing and Pharmacist-Led Antimicrobial Stewardship on Clinical Outcomes in Bloodstream Infections

Author(s) Aisha M. Malhawi, Nawal S. Althpianee, Hend A. Alzamil, Amer S. Alhumaidan, Munayfah Z. Alanazi, Dalal A. Aldawsari, Fahad S. Alanazi
Country Saudi Arabia
Abstract Background: The issue of antimicrobial resistance is concerning across the world, especially in tertiary care teaching hospitals. There is an opportunity for improvement with more timely and precise treatment when RDT is integrated with pharmacist-led antimicrobial stewardship programs.
Objective: To assess the effects of integrated strategies of rapid diagnostic testing and pharmacists’ interventions on the optimization of antimicrobials and clinical outcomes for patients with bloodstream infections.
Methods: A retrospective, quasi-experimental study was performed at a tertiary hospital in Saudi Arabia where two groups were compared; an intervention group who received rapid diagnostic tests, and pharmacists’ stewardship versus a control group who were managed with routine diagnostics. The major aim of the study was ‘time to optimal therapy’ while the secondary aims included: antibiotic de-escalation, length of stay, mortality, and time to organism identification.
Results: Out of a total of 200 patients, the intervention group not only achieved optimal therapy faster but also at a significantly better performance (14.2 vs. 32.5 hours, p < 0.001), higher de-escalation rates (78.3% vs. 45.7%, p < 0.01), shorter LOS (9.4 vs. 12.1 days, p=0.02), and lower in-hospital mortality (7.1% vs. 13.5%, p=0.04). They also showed reduced time to organism identification (5.6 vs 29.4hours, p < 0.001).
Conclusion: The incorporation of timely diagnostics with pharmacist-led initiatives markedly improves the use of antimicrobials and the clinical outcomes for patients. This framework provides a systematic approach to stewardship in comparable healthcare systems.
Keywords Antimicrobial resistance; Hospital outcomes; Saudi Arabia; Antimicrobial stewardship; Bloodstream infections; Rapid diagnostic testing; Pharmacist-led stewardship
Field Medical / Pharmacy
Published In Volume 15, Issue 2, April-June 2024
Published On 2024-05-04
DOI https://doi.org/10.5281/zenodo.15529534
Short DOI https://doi.org/g9mf35
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