Home News Childrens Health News Diagnostic Stewardship Cuts Blood Cultures, Antibiotic Use in PICU

Diagnostic Stewardship Cuts Blood Cultures, Antibiotic Use in PICU

Relative reductions of 33 percent in rate of blood cultures, 13 percent in rate of broad-spectrum antibiotic use seen postimplementation

THURSDAY, May 5, 2022 (HealthDay News) — In the pediatric intensive care unit (PICU), multidisciplinary diagnostic stewardship interventions can reduce blood culture and antibiotic use, according to a study published online May 2 in JAMA Pediatrics.

Charlotte Z. Woods-Hill, M.D., from the Children’s Hospital of Philadelphia, and colleagues examined the association of a 14-site multidisciplinary PICU blood culture collaborative with culture rate, antibiotic use, and patient outcomes in a prospective quality improvement (QI) study. The QI program focused on blood culture practices in the PICU.

The researchers found that the blood culture rate was 149.4 per 1,000 patient-days/month preimplementation and 100.5 per 1,000 patient-days/month postimplementation across the 14 PICUs, representing a relative reduction of 33 percent. The rate of broad-spectrum antibiotic use decreased from 506 to 440 days per 1,000 patient-days/month (13 percent relative reduction) comparing the periods before and after implementation. The rate of broad-spectrum antibiotic initiation decreased from 58.1 to 53.6 initiations/1,000 patient-days/month, which was an 8 percent relative reduction. In addition, there was a 36 percent relative reduction in the rates of central line-associated bloodstream infection, from 1.8 to 1.1 per 1,000 central venous line days/month. Before and after implementation, mortality, length of stay, readmission, sepsis, and severe sepsis/septic shock were similar.

“Our study confirms that diagnostic stewardship is a promising strategy to augment antimicrobial stewardship programs and reduce antibiotic overuse,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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