Department of Pharmacy Practice, University of Maryland Medical Center, Baltimore, Maryland, USA.
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Pharmacotherapy. 2023 Aug;43(8):847-863. doi: 10.1002/phar.2813. Epub 2023 May 22.
Antimicrobial stewardship (AMS) programs have been quick to adopt novel molecular rapid diagnostic technologies (mRDTs) for bloodstream infections (BSIs) to improve antimicrobial management. As such, most of the literature demonstrating the clinical and economic benefits of mRDTs for BSI is in the presence of active AMS intervention. Leveraging mRDTs to improve antimicrobial therapy for BSI is increasingly integral to AMS program activities. This narrative review discusses available and future mRDTs, the relationship between the clinical microbiology laboratory and AMS programs, and practical considerations for optimizing the use of these tools within a health system. Antimicrobial stewardship programs must work closely with their clinical microbiology laboratories to ensure that mRDTs are used to their fullest benefit while remaining cognizant of their limitations. As more mRDT instruments and panels become available and AMS programs continue to expand, future efforts must consider the expansion beyond traditional settings of large academic medical centers and how combinations of tools can further improve patient care.
抗菌药物管理（AMS）计划迅速采用新型分子快速诊断技术（mRDT）来治疗血流感染（BSI），以改善抗菌药物管理。因此，大多数证明 mRDT 对 BSI 的临床和经济效益的文献都在积极的 AMS 干预的情况下。利用 mRDT 来改善 BSI 的抗菌治疗越来越成为 AMS 计划活动的重要组成部分。本叙述性综述讨论了现有的和未来的 mRDT，临床微生物学实验室与 AMS 计划之间的关系，以及在卫生系统中优化这些工具使用的实际考虑因素。抗菌药物管理计划必须与他们的临床微生物学实验室密切合作，以确保 mRDT 得到充分利用，同时认识到它们的局限性。随着更多的 mRDT 仪器和面板的出现以及 AMS 计划的不断扩大，未来的努力必须考虑将其扩展到大型学术医疗中心的传统环境之外，以及工具的组合如何进一步改善患者的护理。
