Table 3.
Antimicrobial Stewardship and Clinical Outcomes by Gram Stain
| Gram-Negative | Gram-Positive | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Pre-BCID (n = 52) | Post-BCID (n = 52) | P Valuea | Total (n = 104) | Pre-BCID (n = 51) | Post-BCID (n = 48) | P Valueb | Total (n = 99) | P Valuec | |
| T0, h | 11 (10–12.5) | 12 (10–15.5) | .1851d | 11.8 (10–14) | 13 (10–18) | 13 (11–16) | .8249 | 13 (11–17) | .0323d |
| TTID, h | 25.8 (18.9–30.3) | 2.6 (2.3–3.1) | <.0001d | 14.5 (2.6–26.7) | 28.8 (23.1–45.7) | 17.4 (3.7–31.8) | .0002 | 25.5 (13.3–36.5) | <.0001d |
| TTS, h | 49.2 (42.6–53.1) | 48.1 (41.4–52.1) | .6134d | 48.3 (42.1–52.5) | 52.8 (46.3–66.9) | 50.9 (44.8–79.5) | .7720 | 52.4 (44.8–74.1) | .0085d |
| Time to first appropriate de-escalation, h | 42.3 (33.0–50.0) | 41.6 (34.1–50.3) | .6866d | 42.1 (33.0–50.2) | 45.6 (31.9–55.6) | 35.1 (20.2–45.8) | .0557 | 38.1 (29.2–51.3) | .4932d |
| Time to first appropriate escalation, h | 11.3 (11.3–11.3) | 11.8 (11.3–36.0) | 1.0000d | 11.6 (11.3–36.0) | 33.8 (5.3–82.0) | 11.2 (5.2–59.5) | .7015 | 20.2 (5.3–59.5) | .6501d |
| Antibiotic change, T0-TTID, No. (%) | 4 (7.7) | 1 (1.9) | .3627f | 5 (4.8) | 8 (15.7) | 10 (20.8) | .5069e | 18 (18.2) | .0027e |
| Antibiotic change, TTID-TTS, No. (%) | 11 (21.2) | 14 (26.9) | .4912e | 25 (24.0) | 15 (29.4) | 17 (35.4) | .5232e | 32 (32.3) | .1892e |
| Antibiotic change, post-TTS, No. (%) | 30 (57.7) | 30 (57.7) | 1.0000e | 60 (57.7) | 18 (35.3) | 17 (35.4) | .9898e | 35 (35.4) | .0014e |
| Any de-escalation, No. (%) | 38 (73.1) | 33 (63.5) | .2921e | 71 (68.3) | 32 (62.7) | 32 (66.7) | .6833e | 64 (64.6) | .5846e |
| Any escalation, No. (%) | 1 (1.9) | 5 (9.6) | .2050f | 6 (5.8) | 7 (13.7) | 7 (14.6) | .9026e | 14 (14.1) | .0454e |
| No antibiotic change, No. (%) | 12 (23.1) | 12 (23.1) | 1.0000e | 24 (23.1) | 14 (27.5) | 11 (22.9) | .6038e | 25 (25.3) | .7173e |
| Length of stay, d | 4 (3–8) | 4 (3–6) | .1116d | 4 (3–7) | 8 (5–17) | 6 (4.8–12.5) | .1441 | 7 (5–15) | <.0001d |
| Discharge to home, No. (%) | 39 (75.0) | 43 (82.7) | .3368e | 82 (78.8) | 34 (66.7) | 32 (66.7) | 1.0000e | 66 (66.7) | .0510e |
| Discharge to facility, No. (%) | 11 (21.2) | 7 (13.5) | .2998e | 18 (17.3) | 15 (29.4) | 13 (27.1) | .7971e | 28 (28.3) | .0619e |
| In-hospital death, No. (%) | 2 (3.8) | 3 (5.8) | 1.0000f | 5 (4.8) | 2 (3.9) | 3 (6.3) | .6716f | 5 (5.1) | 1.0000f |
Data are presented as median (interquartile range) unless otherwise specified.
Abbreviations: BCID, rapid blood culture identification panel; T0, time to positive gram stain; TTS, time to susceptibilities; TTID, time to identification.
aTest between pre-BCID and post-BCID for gram-negative.
bTest between pre-BCID and post-BCID for gram-positive.
cTest between gram-negative and gram-positive.
dWilcoxon test.
eChi-square test.
fFisher exact test.