Adjustment of antibiotic treatment according to the results of blood cultures leads to decreased antibiotic use and costs

Abstract number: p1461

Berild  D., Mohseni  A., Diep  L.M., Jensenius  M., Ringertz  S.H.

Objective: 

To investigate whether the results of blood cultures led to changes in antibiotic use and costs in a university hospital in Norway

Methods: 

Medical records from all patients with positive blood cultures in 2001 were analysed retrospectively. Factors predisposing to infections, results of blood cultures, antibiotic use, and outcome were recorded.

Results: 

The antibiotic use in 226 episodes of true bacteraemia were analysed. According to guidelines empirical antibiotic treatment should be adjusted in 166 episodes. Antibiotic use was adjusted in 146 (88%) of these 166 episodes, which led to a narrowing of therapy in 118 (80%) episodes. Compared to empirical therapy there was a 22% reduction in the number of antibiotics. Adjustment of therapy was more often performed in Gram-negative bacteraemia and polymicrobial cultures than in Gram-positive bacteraemia. In bacteraemia caused by ampicillin-resistant E. coli, ampicillin was mostly replaced by ciprofloxacin. The cost for 7 days adjusted therapy was 19800 EUR (23%) less than for 7 days of empirical therapy.

Conclusion: 

Adjustment of antibiotic use according to results of blood cultures led to improvement of antibiotic use and decreased costs.