A Diagnostic Stewardship Intervention To Improve Blood Culture Use among Adult Nonneutropenic Inpatients: the DISTRIBUTE Study

Author:

Fabre Valeria1ORCID,Klein Eili23,Salinas Alejandra B.1,Jones George1,Carroll Karen C.4,Milstone Aaron M.56,Amoah Joe5,Hsu Yea-Jen7,Gadala Avinash6,Desai Sanjay8,Goyal Amit9,Furfaro David10,Zimmerman Jacquelyn11,Lin Susan12,Cosgrove Sara E.1

Affiliation:

1. Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

2. Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

3. Center for Disease Dynamics, Economics & Policy, Washington, DC, USA

4. Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

5. Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

6. Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland, USA

7. Department of Health Policy and Management, Johns Hopkins Bloomberg of School of Public Health, Baltimore, Maryland, USA

8. Department of Medicine, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

9. Heart & Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA

10. Pulmonary and Critical Care Medicine, Columbia University Medical Center, New York, New York, USA

11. Department of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

12. Department of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA

Abstract

Interventions to optimize blood culture (BCx) practices in adult inpatients are limited. We conducted a before-after study evaluating the impact of a diagnostic stewardship program that aimed to optimize BCx use in a medical intensive care unit (MICU) and five medicine units at a large academic center. The program included implementation of an evidence-based algorithm detailing indications for BCx use and education and feedback to providers about BCx rates and indication inappropriateness. Neutropenic patients were excluded.

Funder

Society for Healthcare Epidemiology of America

HHS | National Institutes of Health

Publisher

American Society for Microbiology

Subject

Microbiology (medical)

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