Table 5.
Cases in which antimicrobials were avoided, started, or stopped as a result of FA testing.
| Action Triggered by FA Result n (%) |
Number of Patients | FA Results (n) | ABx Administered after FA Result | Corresponding Culture Results (n) | |||
|---|---|---|---|---|---|---|---|
| Avoiding ABx 21 (28.0) |
21 (100.0) | Negative FA | N/A | Normal flora (20) H. influenzae (1) |
|||
| Starting ABx 41 (54.7) |
Patients not treated previously 34 (82.9) |
18 (52.9) |
H. influenzae (11) S. pneumoniae (6) MSSA (5) M. catarrhalis (2) |
K. pneumoniae (2) E. coli (1) GBS (1) Negative FA (2) |
ABx for community pathogens CRO (18) |
MSSA (4) K. pnuemoniae (2) E. cloacae (2) S. pneumoniae (1) GBS (1) E. coli (1) |
A. baumannii (1) H. influenzae (1) M. catarrhalis (1) Citrobacter spp. (1) Aspergillus spp. (1) Normal flora (8) |
| 7 (20.6) |
P.aeruginosa (6) E. coli (1) E. cloacae (2) H. influenzae (1) |
K. pneumoniae (2) MSSA (1) A. baumannii (1) Serratia spp. (1) |
ABx for non-fermenters CAZ (5), TZP (2) |
P.aeruginosa (3) E. cloacae (2) MSSA (1) |
K. pnuemoniae (1) Serratia spp. (1) Normal flora (2) |
||
| 4 (11.8) | MSSA (3, one was sputum 104) H. influenzae (2) S. pneumoniae (1) GAS (1) Negative FA (1) |
ABx for MSSA CFZ (3), AMC (1) |
MSSA (2) Normal flora (1) |
||||
| 1 (2.9) | K. pneumoniae, CTX-M (1) | ABx for ESBL ETP (1) |
K. pneumoniae (CRO-Res) | ||||
| 4 (11.8) | MRSA (4, one was sputum 105) P. aeruginosa (1) GAS (1) |
ABx for MRSA VAN (4) |
MRSA (2) P. aeruginosa (1) Aspergillus spp. (1) MSSA (1) Normal flora (1) |
||||
| Patients in “ABx window” 7 (17.1) |
1 (14.3) | MRSA, P.aeruginosa | VAN + TZP | MRSA, P.aeruginosa | |||
| 1 (14.3) | MRSA, E. cloacae (ETA—104), CTX-M | VAN | MRSA, S. maltophilia | ||||
| 1 (14.3) | MSSA, K. pneumoniae | CIP + CFZ | MSSA, K. pneumoniae (CRO-Sus) | ||||
| 1 (14.3) | K. aerogenes | TZP | K. aerogenes (CRO-Sus) | ||||
| 1 (14.3) | MRSA, E. cloacae, CTX-M | VAN + CIP | MRSA, E. cloacae (CRO-Res) | ||||
| 1 (14.3) | MRSA, K. aerogenes | VAN + MEM |
K. aerogenes (CRO-Res) C. striatum |
||||
| 1 (14.3) | P. aeruginosa | CAZ | P. aeruginosa | ||||
| Stopping ABx 13 (17.3) |
11 (84.6) | Negative FA (11) | TZP (2) CXM + AZM (1) CRO (4) CRO + LVX (2) LVX (1) CHL (1) |
Normal flora/yeasts (10) N/A (1) |
|||
| 2 (15.4) |
K. aerogenes (1) MRSA (1) |
MEM (1) TZP (1) |
K. aerogenes (1) MRSA (1) |
||||
FA—FilmArray, ABx—Antibiotics, N/A—not available (no corresponding culture), ETA—endotracheal aspiration, CRO-Res—ceftriaxone resistance, CRO-Sus—ceftriaxone susceptible, MSSA—methicillin sensitive S. aureus, MRSA—methicillin resistant S. aureus, GBS—Streptococcus agalactiae, GAS—Streptococcus pyogenes, CRO—ceftriaxone, TZP—piperacillin-tazobactam, VAN—vancomycin, CFZ—cefazolin, ERT—ertapenem, CIP—ciprofloxacin, MEM—meropenem, CXM—cefuroxime, AZM—azithromycin, LVX—levofloxacin, CHL—chloramphenicol, CST—colistin, SXT—trimethoprim/sulfamethoxazole, VRC—voriconazole, LZD—linezolid, CAZ—ceftazidime, OXA—oxacillin, AMP—ampicillin, AMB—amphotericin B deoxycholate, AMK-amikacin.