Rapid results help medical teams avoid unnecessary use of broad-spectrum antibiotics
Rapid diagnostic testing is a critical component of successful antimicrobial stewardship programs, according to an expert from Blount Memorial Hospital in Maryville, Tennessee. In a recent webinar, Clinical Pharmacy Specialist Brad Crane shared his story of implementing rapid diagnostic testing at his non-teaching community hospital. The webinar also offers helpful tips for anyone interested in starting a similar program.
His experience with rapid diagnostic testing centers on Gram-positive blood cultures, an essential element of the hospital’s antimicrobial stewardship program. The facility runs about 900 blood cultures annually, each one taking two to four days to process. Reducing that turnaround time, Crane reasoned, would give physicians real-time information to help make treatment decisions and limit the unnecessary use of antibiotics.
Rapid Testing Significantly Reduces Patient ICU Stays
Crane lobbied his hospital leadership to adopt rapid testing with the VERIGENE® System, a molecular platform that can produce results from positive blood cultures in just 2.5 hours — including species-level information about organisms detected, plus clinically relevant resistance markers. A pilot study was approved, and Crane reported his findings in the webinar. The three-month study, which used the same three-month period from the prior year as a control, found that rapid diagnostic testing significantly shortened the time to get a patient on the right treatment, which ultimately led to a 40% reduction in the length of patients’ ICU stays. In just three months, antibiotic expenditures went down by $11,000, and overall hospital costs were reduced by $159,000. On an annual basis, that’s an estimated savings of more than $600,000, even factoring in the additional cost of the rapid diagnostic tests.
“This technology really is feasible,” Crane said, noting that it’s not just something that can be deployed by large academic medical centers. Smaller community hospitals like his can see significant benefit from incorporating rapid diagnostic testing. Since the pilot study, his facility has continued to use the VERIGENE System. Today, physicians at Blount Memorial are more willing to wait for test results before starting patients on broad-spectrum antibiotics, which in many cases are not needed at all. Test results can alert the team to the best-targeted antibiotic, or a slate of negative results can point to contaminants in the blood culture rather than a pathogen.
Champion the Need for Rapid Diagnostics
In the presentation, Crane also shared user-friendly advice from his experience. Successful implementation of rapid diagnostics involved having a champion, willing partners in the microbiology lab, the development of simple content to help physicians understand test results and how they inform treatment selection or additional testing, and educating the hospital staff about the accuracy and reliability of the data. He also recommended checking out the IDSA/SHEA guidelines for implementing an antimicrobial stewardship program.
The webinar lasts one hour, including an audience Q&A about practical tips for introducing a new program in a hospital setting. If you’re considering this kind of program, it’s well worth the time.
- Investment Needed in Antimicrobial Stewardship [Blog]
- Sepsis guidelines and diagnostics: Current impact and future outlook [MLO Online]
- The Clinical and Economic Case for Rapid Sepsis Diagnostics [Webinar]
- Trends in Microbial Testing and Antibiotic Resistance Detection [Blog]
- Bloodstream Infection Product Portfolio [Web Page]