ArticleJournal of the Pediatric Infectious Diseases Society2017
Clinical Impact and Provider Acceptability of Real-Time Antimicrobial Stewardship Decision Support for Rapid Diagnostics in Children With Positive Blood Culture Results.
Article in Journal of the Pediatric Infectious Diseases Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rapid Diagnostic Tests and Antimicrobial Stewardship Programs for the Management of Bloodstream Infection: What Is Their Relative Contribution to Improving Clinical Outcomes? A Systematic Review and Network Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Pooled it
- Effect of Rapid Respiratory Virus Testing on Antibiotic Prescribing Among Children Presenting to the Emergency Department With Acute Respiratory Illness: A Randomized Clinical Trial.JAMA network open · 2021Trial
- Implementation of multiplex PCR-based blood culture identification among hospitalized pediatric patients at a tertiary care center.Microbiology spectrum · 2026Article
- Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection.Microorganisms · 2026Article
- Antimicrobial and diagnostic stewardship: opportunities for return on investment.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Observational
- Opportunities for collaboration: the synergy between antimicrobial and diagnostic stewardship in pediatrics.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Review
- Article
- Diagnosis and Management of Neonatal Bacterial Sepsis: Current Challenges and Future Perspectives.Tropical medicine and infectious disease · 2024Review
- Breaking Boundaries in Pneumonia Diagnostics: Transitioning from Tradition to Molecular Frontiers with Multiplex PCR.Diagnostics (Basel, Switzerland) · 2024Review
- Stop in Time: How to Reduce Unnecessary Antibiotics in Newborns with Late-Onset Sepsis in Neonatal Intensive Care.Tropical medicine and infectious disease · 2024Review
- The impact of the BIOFIREEuropean journal of pediatrics · 2024Article
- Article
- Blood culture identification (BCID) performance in polymicrobial bacteremia.Diagnostic microbiology and infectious disease · 2023Article
- Identification of microorganisms by a rapid PCR panel from positive blood cultures leads to faster optimal antimicrobial therapy - a before-after study.BMC infectious diseases · 2023Observational
- Influence of Multiplex PCR in the Management of Antibiotic Treatment in Patients with Bacteremia.Antibiotics (Basel, Switzerland) · 2023Article
- Rapid Diagnostic Test Value and Implementation in Antimicrobial Stewardship Across Low-to-Middle and High-Income Countries: A Mixed-Methods Review.Infectious diseases and therapy · 2023Article
- Test Performance and Potential Clinical Utility of the GenMark Dx ePlex Blood Culture Identification Gram-Negative Panel.Microbiology spectrum · 2023Article
- Performance of the BioFire Blood Culture Identification 2 panel for the diagnosis of bloodstream infections.Heliyon · 2022Article
- Clinical and Financial Impact of a Diagnostic Stewardship Program for Children with Suspected Central Nervous System Infection.The Journal of pediatrics · 2022Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundRapid diagnostic technologies for infectious diseases have the potential to improve clinical outcomes, but guideline-recommended antimicrobial stewardship (AS) strategies are not currently optimized for rapid intervention. We evaluated the clinical impact and provider acceptability of implementing real-time AS decision support for children with positive blood culture results according to the FilmArray blood culture identification panel (BCID [BioFire Diagnostics]) at Children's Hospital Colorado.
methodsA pre-post quasi-experimental design was used to compare the outcomes of 100 postintervention children with positive blood culture results matched with 200 preintervention control children. Causative organisms in the preintervention group were identified using conventional microbiologic techniques and communicated to providers by a microbiology technologist. Postintervention organisms were identified by the BCID and communicated by an AS provider in real time with interpretation and antimicrobial recommendations. The primary outcome was time to optimal antimicrobial therapy (time from blood culture collection to start of predetermined pathogen-specific regimen or antimicrobial discontinuation for contaminants) compared by a log-rank test and Kaplan-Meier analysis. Provider acceptability of the intervention was assessed via E-mailed surveys.
resultsThe median time to optimal therapy decreased from 60.2 hours before intervention to 26.7 hours after intervention (P = .001). Among children with blood cultures that contained true pathogens, the time to effective antimicrobial therapy decreased from 6.9 to 3.4 hours (P = .03). Unnecessary antibiotic initiation for children with a culture that contained organisms considered to be contaminants decreased from 76% to 26% (P < .001). Providers reported a change in management as a result of BCID results in 73% of the cases and a mean overall satisfaction rating of 4.8 on a 5-point Likert scale.
conclusionsReal-time AS decision support for rapid diagnostics is associated with improved antimicrobial use and high satisfaction ratings by providers.
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