LABORATORY PRACTICES FOR REPORTING BACTERIAL SUSCEPTIBILITY TESTS THAT AFFECT ANTIBIOTIC-THERAPY

Objective.-To evaluate a laboratory-based process for integrating anti microbial susceptibility, pharmacy, and clinical data with rapid physi cian notification to improve the care and outcome of patients with bac terial infections. Design.-Randomized case control study comparing sta ndard microbiology reporting method with a targeted notification proce dure. Results.-Of 254 cases studied, a discordance between antimicrobi al susceptibility test results and antibiotic therapy was detected in 140 (55%) patients and confirmed after clinical review in 49 (19%). Ap propriate changes in antibiotic therapy were made significantly sooner and in a significantly higher proportion of cases with targeted notif ication than with standard reporting procedures. Conclusions.-Utilizat ion of antimicrobial susceptibility results is improved by integrating clinical and therapeutic information to identify cases that require p hysician notification, as measured by the timeliness and appropriatene ss of antibiotic treatment.