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Cited by 36Bacterial Identification and Susceptibility TestingAntibiotic Use and ResistanceAntibiotic Resistance in Bacteria

Evaluating the impact of rapid antimicrobial susceptibility testing for bloodstream infections: a review of actionability, antibiotic use and patient outcome metrics

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MacVane, Shawn H, Dwivedi, Hari P·2024·Journal of Antimicrobial Chemotherapy
DOI 10.1093/jac/dkae282PMC PMC11412245
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Abstract

Antimicrobial susceptibility testing (AST) is a core function of the clinical microbiology laboratory and is critical to the management of patients with bloodstream infections (BSIs) to facilitate optimal antibiotic therapy selection. Recent technological advances have resulted in several rapid methods for determining susceptibility direct from positive blood culture that can provide turnaround times in under 8 h, which is considerably shorter than conventional culture-based methods. As diagnostic results do not directly produce a medical intervention, actionability is a primary determinant of the effect these technologies have on antibiotic use and ultimately patient outcomes. Randomized controlled trials and observational studies consistently show that rapid AST significantly reduces time to results and improves antimicrobial therapy for patients with BSI across various methods, patient populations and organisms. To date, the clinical impact of rapid AST has been demonstrated in some observational studies, but randomized controlled trials have not been sufficiently powered to validate many of these findings. This article reviews various metrics that have been described in the literature to measure the impact of rapid AST on actionability, antibiotic exposure and patient outcomes, as well as highlighting how implementation and workflow processes can affect these metrics.

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  • Improvements in TAT and faster treatment adaptation have been attributed to better outcomes in patients with BSI, including improved survival rates in some studies.

    “While the exact cause of this finding cannot be determined due to the observational nature of the study, improvements in TAT and faster treatment adaptation have been attributed to better outcomes in patients with BSI, including improved survival rates in some studies [23–25].”

    From Lab efficiency and improvements in the management of bloodstream infections: a before and after study (2025) · cites this paper as [24]

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Cited by

Sorted by citations

Authors
MacVane, S. H., & Dwivedi, H. P.
Affiliations
bioMérieux (United States) (US)
Corresponding author
MacVane, Shawn H
ORCID
Venue
Journal of Antimicrobial Chemotherapy
Publisher
Oxford University Press (OUP)
Published
2024-09
Volume
79
Issue
Supplement_1
Pages
i13-i25
ISSN
  • 0305-7453 (ISSN-L)
  • 1460-2091
DOI
10.1093/jac/dkae282
PMC
PMC11412245
OpenAlex
W4402635950
Cited by
36
References
2
Citations by year
2026: 16 · 2025: 20
FWCI
2.00
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Antimicrobial Chemotherapy (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • bioMérieux
  • Marcy-l’Étoile
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
Keywords
rapid susceptibility testing, bloodstream infection, blood culture, actionability, antibiotic use, patient outcomes, turnaround time, antimicrobial stewardship, laboratory workflow
MeSH terms
Blood Culture, Antimicrobial Stewardship, Anti-Bacterial Agents, Bacteria, Humans, Microbial Sensitivity Tests, Time Factors, Randomized Controlled Trials as Topic, Bacteremia, Treatment Outcome

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