Rapid organism identification and antimicrobial tailoring are key components of antimicrobial stewardship programs (ASP). Rapid diagnostic technologies (RDT) have significantly reduced identification time, but clinician awareness may be limited. The purpose of this study was to determine the familiarity and utilization of RDT in ASP activities.
This study was IRB approved. A survey was distributed to 2 email list serves comprised of infectious diseases (ID) focused pharmacists [SIDP and the ACCP ID-PRN]. Demographics, positive result actions, and reported RDT outcomes were evaluated. Knowledge of various RDTs was assessed via a 5 point Likert scale. Group comparisons were analyzed using Chi-square (alpha=0.05).
There were 224 responses representing 46 states and 9 countries. The majority of respondents (87.9%) worked at a facility with >0.5 FTE dedicated to ASP. Respondent’s familiarity [defined as somewhat familiar or very familiar] was highest with polymerase chain reaction (PCR) (94%), and lowest with Multiplex PCR (58%). The majority of sites have had RDT for ≤3 yrs. Respondents with formal ID training were more familiar with all 5 tests compared to non-ID trained (p< 0.05). There were no differences (p >0.05) in familiarity of each method by practice site (teaching, community, other) with the exception of MALDI TOF (40%,22%,22%, respectively; p =0.015).
RDT alerts were most frequently received by stewardship pharmacists (n=81) and floor nurses (n=60), Only 48% received alerts in real time. Most respondents (67.4%) have not assessed the impact of RDTs, but when tracked, decreased time to de-escalation/targeted therapy was the most common outcome reported (n=47). Measurement of impact on LOS, mortality, and hospital costs was infrequent.
RDT use in ASP activities is common, but relatively new. ASP pharmacists receive the alerts the most frequently, but not always in real time. ID training improves self-assessed knowledge about RDTs as compared to those without formal training. Educational programs should be targeted towards enhancing pharmacists’ knowledge and utility of such tests and further research is needed to evaluate the impact of RDT on patient and ASP outcomes.
M. V. Mahoney,
K. Kuper, None
P. B. Bookstaver, Allergan Pharmaceuticals: Scientific Advisor , Research grant
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