Department of Pathology & Laboratory Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Clin Chem. 2021 Dec 30;68(1):75-82. doi: 10.1093/clinchem/hvab206.
Diagnostic stewardship is an important partner to antimicrobial stewardship.
Diagnostic stewardship focuses on ensuring correct diagnosis of infectious diseases while antimicrobial stewardship aims to optimize antimicrobial treatment. Both aim to improve patient outcomes. Diagnostic stewardship involves interventions that reduce testing in patients with low pretest probability, optimize a test's likelihood ratio, and seek to warn providers when suboptimal test results might have been reported.
Diagnostic stewardship interventions have been described primarily in the areas of urinary tract infection, Clostridioides difficile infection, and bloodstream infection diagnosis. However, emerging areas include pneumonia and wound infections in addition to optimization of multiplexed panel-based testing.
诊断管理是抗菌药物管理的重要伙伴。
诊断管理侧重于确保正确诊断传染病,而抗菌药物管理旨在优化抗菌治疗。两者都旨在改善患者的预后。诊断管理包括减少低预测试概率患者的检测、优化检测的似然比,并在可能报告了不理想的检测结果时提醒提供者的干预措施。
诊断管理干预措施主要在尿路感染、艰难梭菌感染和血流感染诊断领域进行了描述。然而,除了优化基于多重检测的面板检测外,新出现的领域还包括肺炎和伤口感染。