From bottle to bedside: Implementation considerations and antimicrobial stewardship considerations for bloodstream infection rapid diagnostic testing

Pharmacotherapy. 2023 Aug;43(8):847-863. doi: 10.1002/phar.2813. Epub 2023 May 22.

Abstract

Antimicrobial stewardship (AMS) programs have been quick to adopt novel molecular rapid diagnostic technologies (mRDTs) for bloodstream infections (BSIs) to improve antimicrobial management. As such, most of the literature demonstrating the clinical and economic benefits of mRDTs for BSI is in the presence of active AMS intervention. Leveraging mRDTs to improve antimicrobial therapy for BSI is increasingly integral to AMS program activities. This narrative review discusses available and future mRDTs, the relationship between the clinical microbiology laboratory and AMS programs, and practical considerations for optimizing the use of these tools within a health system. Antimicrobial stewardship programs must work closely with their clinical microbiology laboratories to ensure that mRDTs are used to their fullest benefit while remaining cognizant of their limitations. As more mRDT instruments and panels become available and AMS programs continue to expand, future efforts must consider the expansion beyond traditional settings of large academic medical centers and how combinations of tools can further improve patient care.

Keywords: antimicrobial stewardship; bloodstream infections; implementation; rapid diagnostics.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents* / therapeutic use
  • Antimicrobial Stewardship*
  • Humans
  • Rapid Diagnostic Tests
  • Sepsis* / diagnosis
  • Sepsis* / drug therapy

Substances

  • Anti-Infective Agents
  • Anti-Bacterial Agents