Hospital pharmacists serve a critical leadership role in fighting antimicrobial resistance. They can reduce the administration of empiric therapy when it is not necessary while ensuring the patients suspected of sepsis receive targeted treatment as soon as possible. The spread of carbapenemase-producing Enterobacteriaceae (CPE) is a threat to healthcare delivery, although its extent differs substantially from country to country, according to authors who surveyed national experts from 39 countries 1. The results from this paper highlight an urgent need for a coordinated European effort on early diagnosis, active surveillance and guidance on infection control members.
Dangers of delaying treatment: Delays in test results based on blood-culture-dependent methods put hospital pharmacists and stewardship committee members at a major disadvantage. Their only choice is to use empiric therapy for all patients suspected of sepsis. This results in:
- Overtreatment of patients that don’t need antibiotics
- Undertreatment of patients with real infections that do need antibiotics
- Overutilization of gram-positive and gram-negative therapies, leading to antibiotic resistance, potential side effects (such as acute kidney injury) or unidentified bloodstream infections progressing to sepsis or septic shock
- Higher mortality rates, which increase by approximately 8% for each hour appropriate antibiotic treatment is delayed in patients with septic shock
Faster, targeted therapy: Using T2Direct Diagnostics™, hospital pharmacists can determine accurate species identification in 3 to 5 hours and quickly recommend the most appropriate treatment.
What is your stewardship challenge? Learn how T2 can help.
The T2Bacteria® and T2Candida® Panels have demonstrated high specificity (>98%) in independent studies covering over 3,000 patients in more than 15 institutions.2,3 They can detect the most prevalent and common ESKAPE pathogens, enabling faster targeted therapy for patients with bloodstream infections. And with exceptionally high negative predictive values (NPV) throughout a hospital – typically 98- 99% or more – the Panels have proven to provide stewardship teams with the confidence to safely de-escalate empiric therapy and spare negative side effects for patients.
- The decreased utilization of empirical micafungin therapy at Lee Health more than covered the cost of testing patients throughout their institution.4
- Huntsville Hospital reported pharmacy savings that also more than covered the full cost of testing patients throughout their institution.5 Huntsville also reported that 64% of negative patients had therapy avoided or de-escalated, resulting in a decreased average duration of micafungin therapy by 2.1 days.6
- In a University of Pittsburgh Medical Center study, investigators demonstrated the T2Candida Panel reduced median antifungal days of therapy per patient by 11 days, a nearly 50% reduction in antifungal use, and shorter times to start antifungal therapy among patients with invasive candidiasis.7
- At Robert Wood Johnson Hospital, antifungal therapy was avoided or ceased in 67% of patients with a negative T2Candida result.8
Investigators from Lee Health demonstrated detection of all organisms identified by blood culture and significant de-escalation opportunities due to a negative S. aureus or negative P. aeruginosa results.9
*Henry Ford Health System demonstrated patients tested with the T2Candida Panel were treated in a median of 5 hours – more than an eightfold improvement compared to blood culture.10 Similarly, Lee Health found the time to initiation of appropriate antifungal therapy was only 6 hours from the time of blood draw in the T2Candida-positive patients.4 T2Direct Diagnostics tools can help de-escalate therapy, leading to pharmacy savings and reduced nephrotoxic side effects on patients. Hospitals, including Lee Health, Huntsville Hospital, and University of Pittsburgh Medical Center, have reported antifungal savings that more than covered the full cost of testing at their institutions, with as much as a 2.1 day reduction of micafungin therapy per patient.4,6,7
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