Rapid molecular diagnostic tests in patients with bacteremia: evaluation of their impact on decision making and clinical outcomes.
We performed a systematic review of the data regarding rapid diagnostic tests and their advantages or limitations on patients' clinical outcomes. The PubMed and Scopus databases were searched independently by two reviewers. Mortality was the primary outcome. Most studies compared rapid tests with blood cultures. Although not observed in all studies, only studies comparing rapid tests in conjunction with antimicrobial stewardship programs (ASPs) showed a mortality benefit. A reduction in hospital or intensive care unit (ICU) length of stay was also observed in almost all studies when the rapid tests, with or without ASPs, were used. Finally, treatment decisions were taken earlier in the rapid test groups. Despite a faster treatment decision, a clear mortality benefit was not seen when rapid tests were used. It is crucial to differentiate the influence of rapid tests from that of ASPs and clarify the actual effect of each factor separately.
Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23, Marousi, Athens, Greece.|Department of Internal Medicine-Infectious Diseases, Iaso General Hospital, Athens, Greece.
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Vardakas
Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23, Marousi, Athens, Greece.
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Anifantaki
Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23, Marousi, Athens, Greece.
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Trigkidis
Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23, Marousi, Athens, Greece. m.falagas@aibs.gr.|Department of Internal Medicine-Infectious Diseases, Iaso General Hospital, Athens, Greece. m.falagas@aibs.gr.|Department of Medicine, Tufts University School of Medicine, Boston, MA, USA. m.falagas@aibs.gr.
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Falagas
D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy*; D003657:Decision Making; D042241:Early Diagnosis; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D055502:Secondary Prevention; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome