European Journal of Clinical Microbiology and Infectious Diseases

, Volume 19, Issue 7, pp 493–500

Clinical Impact of an Infectious Disease Service on the Management of Bloodstream Infection

Authors

  • U. Fluckiger
    • Division of Infectious Diseases and Clinical Epidemiology, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland e-mail: awidmer@uhbs.ch
  • W. Zimmerli
    • Department of Internal Medicine, Liestal University Hospital, Switzerland
  • H. Sax
    • Division of Infectious Diseases, Geneva University Hospital, 1211 Geneva 14, Switzerland
  • R. Frei
    • Bacteriology Laboratory, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland
  • A. F. Widmer
    • Division of Infectious Diseases and Clinical Epidemiology, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland e-mail: awidmer@uhbs.ch
Article

DOI: 10.1007/s100960000306

Cite this article as:
Fluckiger, U., Zimmerli, W., Sax, H. et al. EJCMID (2000) 19: 493. doi:10.1007/s100960000306

Abstract

 The impact of an infectious disease (ID) service on the optimal antibiotic management of 103 patients with bloodstream infections, defined as bacteremia and systemic inflammatory response syndrome, was evaluated. The optimal antibiotic management was defined according to the Sanford Guide to Antimicrobial Therapy (1996) or written internal guidelines. The judgment on optimal antibiotic management was made at the time of reporting the positive blood culture results. Switching from a broad-spectrum to a narrow-spectrum agent was carried out significantly more often by the ID service than by the attending physicians (25 of 25 vs. 20 of 40;P<0.001). In patients without empirical therapy, the ID service initiated optimal antimicrobial therapy significantly more often than physicians without training in infectious diseases (12 of 12 vs. 4 of 10, P=0.0028). Three of 12 patients in whom the attending physician misinterpreted the positive blood culture result needed 8 days to 4 months of additional hospitalization. In summary, patients for whom an ID service was provided received appropriate treatment more often and experienced significantly fewer complications.

Copyright information

© Springer-Verlag Berlin Heidelberg 2000