Table 2.
Data on Defined Antimicrobial Management Outcomes of Included Studies
| Author | Antimicrobial Treatment Adjustments | Appropriate Treatment | Time to Treatment Adjustment, h | Time to Appropriate Treatment, h |
|---|---|---|---|---|
| Tafelski [20] | Adjustments: 13.5% vs 9.8%a | - | 38.8 vs 18.8 (ns)a | - |
| Bhat [21] | Total adjustments: 15 vs 165 (P < .001)a; 5.8 vs 2.6 (P < .001)a antibiotics/patient | - | - | - |
| Cambau [22] | - | 23.6% vs 33.6% (P < .0001)a of patients | - | - |
| Lodes [25] | Adjustment: 25 (16.9%) | - | - | - |
| Mancini [23] | 61.67% vs 62.5% (P = 1) | - | - | - |
| Bloos [42] | - | - | - | - |
| Wallet [43] | Adjusted: 3 patients based on SF | - | - | - |
| Bravo [26] | Inappropriate addition: 2 neutropenic cases | Appropriate adjustment: 5 neutropenic cases | - | - |
| Appropriate adjustment: 10/13 ICU patients | ||||
| Maubon [27] | - | Adequate treatment: 4/32 | Earlier treatment: 4/32 BC+ | - |
| Adequate duration: 1/32 | Immediate prescription: 3 (2.8%) | |||
| Improved initial treatment: 11 (10%) | ||||
| Bloos [32] | - | 24.2% of PCR results suggest a de-escalation | - | - |
| Inadequate treatment: 34% of patients with PCR-positive result | ||||
| Tran [28] | - | Inadequate antibiotics: 29.2% PCR+ vs 18.7% BC+ patients | - | - |
| Vincent [34] | Adjustment recommendation: 41% | - | - | - |
| O’Dwyer [40] | - | - | - | - |
| Muñozb [38] | - | - | - | |
| Muñozb [39] | - | - | - | - |
| Dierkes [30] | Adjustment: 8/27 would be triggered | - | 3 of 8 adjustments would have been made earlier | - |
| Alvarez [37] | Reduced use of antibiotics: 5.1 vs 4.2 (P < .05)a | - | - | - |
| Lehmann [29] | Adjustment suggested by PCR result: 46 episodes | - | - | 22.8 days on early adequate treatment per 100 tests |
| Tschiedel [24] | Adjustment: 18%, 9 positive and 5 negative cases | - | - | - |
| Herne [31] | Adjustment: 38.9% of positive cases (7.4% de-escalation, 25.9% escalation) | - | - | - |
| Bloos [33] | - | - | - | 67.5 vs 31.0 (P < .01)a |
| Patch [35] | - | Antifungal treatment without positive blood cultures or positive T2MR: 42.8% and 41.6% | - | 34 h vs 6 h (P = .0013)a |
| McCann [44] | - | - | - | - |
| Gebert [45] | - | - | 5.7 h time difference between PCR result and positive signaling | - |
| Dryden [36] | - | Appropriate stewardship outcome: 73.6% | - | - |
| Inappropriate stewardship outcome: 23.9% |
Abbreviations: BC, blood culture; ICU, intensive care unit; ns, not significant; PCR, polymerase chain reaction.
aControl vs intervention.
bThese studies did not evaluate the impact on antimicrobial therapy. They were included because they assessed the impact on clinical severity; results are shown in Table 3.