Laboratory practices for reporting bacterial susceptibility tests that affect antibiotic therapy.

OBJECTIVE

To evaluate a laboratory-based process for integrating antimicrobial susceptibility, pharmacy, and clinical data with rapid physician notification to improve the care and outcome of patients with bacterial infections.

DESIGN

Randomized case control study comparing standard microbiology reporting method with a targeted notification procedure.

RESULTS

Of 254 cases studied, a discordance between antimicrobial susceptibility test results and antibiotic therapy was detected in 140 (55%) patients and confirmed after clinical review in 49 (19%). Appropriate changes in antibiotic therapy were made significantly sooner and in a significantly higher proportion of cases with targeted notification than with standard reporting procedures.

CONCLUSIONS

Utilization of antimicrobial susceptibility results is improved by integrating clinical and therapeutic information to identify cases that require physician notification, as measured by the timeliness and appropriateness of antibiotic treatment.