The purpose of this study is to evaluate whether the use of direct rapid antibiotic susceptibility test (dRAST), in addition to the current standard antibiotic susceptibility test, can increase the proportion of patients with hematologic disease who received appropriate antibiotics in early period of bacteremia.
* patients with hematologic diseases who have high risk of bacteremia, because of immune suppression treatment or intensive chemotherapy or bone marrow transplantation which these patients had received, will be recruited in tertiary referral medical centers. * All the participants will be randomly assigned into either dRAST group or current standard antibiotic susceptibility test group. * All the participants in the both arms will receive antimicrobial stewardship by infectious disease specialists. Antimicrobial stewardship will be performed at each timepoint of Gram stain results reporting, dRAST results reporting, and current method reporting. * Target numbers are 58 and 58, respectively. * All the participants will be monitored for general medical conditions such as vital sign and response to antibiotic treatment by infectious disease specialists for 1 week. * The percentage of patients who received optimal targeted antibiotics 72 hours after blood collection for blood culture will be evaluated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
116
Infectious diseases specialists will do active antimicrobial stewardship according to dRAST results in addition to Gram staining results and current standard method.
Infectious diseases specialists will do active antimicrobial stewardship according to Gram staining results, and current standard method without dRAST results.
Seoul National University Hospital
Seoul, South Korea
Percentage of patients receiving optimal targeted antibiotics 72 hours after blood collection for blood culture
The percentage of patients receiving optimal targeted antibiotics antibiotics which is defined as most effective and narrowest antibiotics based on susceptibility testing results, 72 hours after blood collection for blood culture
Time frame: 72 hour after blood culture collection
Time to optimal targeted antibiotics
The time to the optimal targeted antibiotics administration after blood culture collection
Time frame: Time from first blood culture collection up to 1 month
Amount of broad-spectrum antibiotics use
The duration of use of major antibiotics (vancomycin, carbapenem)
Time frame: Time from first blood culture collection up to 1 week
Time to defervescence
Time from the time of blood culture collection to the time of fever resolution
Time frame: Time from first blood culture collection up to 1 month
proportion of positive blood culture 48 hours after first blood culture
proportion of positive blood culture 48 hours after first blood culture
Time frame: Time from blood culture collection up to 1 month
30-day mortality rate related with bacteremia
30-day mortality rate related with bacteremia
Time frame: Time from blood culture collection up to 30-day
Percentage of patients receiving optimal targeted antibiotics 48 hours after
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
The percentage of patients receiving optimal targeted antibiotics antibiotics which is defined as most effective and narrowest antibiotics based on susceptibility testing results, 48 hours after blood collection for blood culture
Time frame: 48 hour after blood culture collection
Percentage of patients receiving unnecessary broad spectrum antibiotics 48 hours after
The percentage of patients receiving unnecessary broad spectrum antibiotics which is defined as administration of antibiotics to which organisms were susceptible, but had broad-spectrum activity requiring de-escalation or discontinuing administration, 48 hours after blood collection for blood culture
Time frame: 48 hour after blood culture collection
Percentage of patients receiving unnecessary broad spectrum antibiotics 72 hours after
The percentage of patients receiving unnecessary broad spectrum antibiotics which is defined as administration of antibiotics to which organisms were susceptible, but had broad-spectrum activity requiring de-escalation or discontinuing administration, 72 hours after blood collection for blood culture
Time frame: 72 hour after blood culture collection
Percentage of patients receiving ineffective antibiotics 48 hours after
The percentage of patients receiving ineffective antibiotics which is defined if the organisms were not susceptible, 48 hours after blood collection for blood culture
Time frame: 48 hour after blood culture collection
Percentage of patients receiving ineffective antibiotics 72 hours after
The percentage of patients receiving ineffective antibiotics which is defined if the organisms were not susceptible, 72 hours after blood collection for blood culture
Time frame: 72 hour after blood culture collection