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Ushering in Diagnostic Stewardship: a Step Towards Antibiotic Stewardship
- Source :
- Current Treatment Options in Infectious Diseases. 12:202-214
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- In recent years, there have been significant developments in rapid diagnostic techniques (RDTs) in microbiology for the diagnosis of infectious diseases. By providing a more rapid diagnosis, RDTs have the potential to affect diagnostic algorithms and therapeutic decisions. In addition to “antibiotic stewardship,” the term “diagnostic stewardship” has recently been coined in clinical practice and denotes the promotion of a rational implementation of diagnostic tests with a view to improving the quality of care and safely reducing cost. This review explores the advancement of diagnostic and antibiotic stewardship in the implementation of RDTs and describes the most relevant related clinical applications in Clostridioides difficile infections (CDIs), bloodstream infections (BSIs), and respiratory infections. An innovative evidence-based RDT diagnostic algorithm that varies according to the presence of pre-agreed institutional criteria significantly increases testing accuracy for differentiating CDIs from carriage status. Evidence on BSIs reveals that pairing RDTs and antibiotic stewardship eases timely and appropriate utilization of RDTs results that may improve the clinical outcomes by optimizing antibiotic use. Data on clinical implications of RDTs targeting antibiotic-resistant Gram-negative and respiratory infections are scarce and inconclusive. Intertwining the role of diagnostic and antibiotic stewardship is crucial to optimizing RDTs utilization, by ensuring that RDTs are rationally selected and implemented, and results correctly interpreted and applied to clinical practice. Further research is needed to explore the clinical implications of RDT implementation.
- Subjects :
- 0301 basic medicine
Cultural Studies
Linguistics and Language
History
medicine.medical_specialty
030106 microbiology
Language and Linguistics
03 medical and health sciences
0302 clinical medicine
parasitic diseases
medicine
030212 general & internal medicine
Antibiotic use
Quality of care
Intensive care medicine
health care economics and organizations
business.industry
Diagnostic test
Diagnostic algorithms
equipment and supplies
Clinical Practice
Anthropology
Antibiotic Stewardship
Stewardship
business
Clostridioides
Subjects
Details
- ISSN :
- 15346250
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Current Treatment Options in Infectious Diseases
- Accession number :
- edsair.doi...........aa07b92e78d3c2a55004cb15f0020e3c
- Full Text :
- https://doi.org/10.1007/s40506-020-00224-7