Diagnostic Stewardship Beneficial in Ventilator-Associated Pneumonia

A diagnostic stewardship intervention care bundle (DSI-CB) for ventilator-associated pneumonia (VAP) was safe, feasible, and associated with significant decreases in positive respiratory cultures and antibiotic utilization rates in the ICU (ICUAURs), according to results published in Open Forum Infectious Diseases. Owen Albin, MD, and colleagues conducted a pilot/feasibility trial in two ICUs using a DSI-CB targeting the respiratory culture testing pathway. Of 1,810 patients admitted, 29% were eligible for the DSICB, and it was utilized in 77% of this group. The DSI-CB was associated with substantial decreases in rates of total respiratory cultures ordered and positive respiratory cultures. An interrupted time series analyses of ICU-AURs in patients receiving mechanical ventilation showed that both total antibiotic days of therapy per day and broad-spectrum antibiotic days of therapy per day declined significantly following DSI-CB implementation (P=0.05 and P=0.01, respectively). “This represents the first trial of a DSI targeting VAP [and] a novel avenue for ICU antimicrobial stewardship,” Dr. Albin and colleagues wrote.