Comparison of Pharmacist-Directed Management of Multiplex PCR Blood Culture Results with Conventional Microbiology Methods on Effective and Optimal Therapy within a Community Hospital

Allison M Porter; Christopher M Bland; Henry N Young; David R Allen; Sabrina R Croft; R Ellen Gayheart; Parks W Miller; Rachel J Musgrove; Emilee M Robertson; Geneen M Gibson

doi:10.1128/AAC.01575-18

Comparison of Pharmacist-Directed Management of Multiplex PCR Blood Culture Results with Conventional Microbiology Methods on Effective and Optimal Therapy within a Community Hospital

Antimicrob Agents Chemother. 2018 Dec 21;63(1):e01575-18. doi: 10.1128/AAC.01575-18. Print 2019 Jan.

Authors

Allison M Porter^{1

2}, Christopher M Bland^{3

2}, Henry N Young², David R Allen³, Sabrina R Croft^{3

2}, R Ellen Gayheart⁴, Parks W Miller³, Rachel J Musgrove³, Emilee M Robertson³, Geneen M Gibson^{3

2}

Affiliations

¹ Department of Pharmacy, St. Joseph's/Candler Health System, Savannah, Georgia, USA alliporter236@gmail.com.
² University of Georgia College of Pharmacy, Athens, Georgia, USA.
³ Department of Pharmacy, St. Joseph's/Candler Health System, Savannah, Georgia, USA.
⁴ Department of Microbiology, St. Joseph's/Candler Health System, Savannah, Georgia, USA.

Abstract

Multiplex PCR combined with a pharmacist-driven reporting protocol was compared to the standard of care within a community hospital to evaluate initial changes after notification of a positive blood culture. The intervention group demonstrated decreased times to changes in antimicrobial therapy (P = 0.0081), increased changes to optimal antimicrobial therapy (P = 0.013), and decreased vancomycin use for coagulase-negative staphylococcus contaminants (P < 0.01) with multiplex PCR implementation and pharmacist intervention.

Keywords: community; mRDT; pharmacy; rapid diagnostic test; stewardship.

MeSH terms

Anti-Bacterial Agents / therapeutic use*
Antimicrobial Stewardship / statistics & numerical data*
Bacteremia / diagnosis
Bacteremia / drug therapy*
Bacteremia / microbiology
Bacterial Typing Techniques
Blood Culture / statistics & numerical data*
Gram-Negative Bacteria / classification
Gram-Negative Bacteria / drug effects
Gram-Negative Bacteria / isolation & purification
Gram-Positive Bacteria / classification
Gram-Positive Bacteria / drug effects
Gram-Positive Bacteria / isolation & purification
Hospitals, Community
Humans
Multiplex Polymerase Chain Reaction
Pharmacists / statistics & numerical data*
Retrospective Studies
Time-to-Treatment / statistics & numerical data*

Substances

Anti-Bacterial Agents