Appropriateness of Antibiotic Treatment Review following Blood Culture Collection

Objective Inappropriate antibiotic treatment can significantly affect antimicrobial resistance, resulting in treatments becoming less effective in the future. Previous studies have not identified the possible de-escalation rate. The aim of this study was to assess the appropriateness of antibiotic treatment in patients who have a blood culture collected, in particular, calculating how many days of antibiotics can be de-escalated.

Methods A patient series, observational study was conducted that included all patient blood culture, regardless of whether they were positive or negative, over a period of 4 days. The study was repeated three times to attain a larger sample. The adequacy of antibiotic treatment was determined based on microbiology results, prescription drug administration, and patient notes/charts.

Results Of the 69 suitable cases, 36 (52.17%) received appropriate treatment and 33 (47.83%) received inappropriate treatment. Of the inappropriate cases, it was calculated that 83 days of de-escalation were possible. Fifteen (21%) of the cases could have de-escalated use of meropenem.

Conclusion The results highlight that there is opportunity to review and de-escalate patient's treatment, after taking a blood culture and practices such as rationalizing antibiotic choices and educating physicians on reviewing antibiotics is appropriate.