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New Test Assists Physicians with Quicker Treatment Decisions for Sepsis

Accepted submission by martyb at 2019-10-03 22:58:58 from the know what you are dealing with dept.
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New Test Assists Physicians with Quicker Treatment Decisions for Sepsis [vumc.org]:

“Randomized Clinical Trial Evaluating Clinical Impact of RAPid Identification and Antimicrobial Susceptibility Testing for Gram-Negative Bacteremia (RAPIDS-GN),” is the largest study to evaluate the clinical impact of rapid blood culture diagnostics in the management of patients with Gram-negative bacilli bloodstream infections.

The results demonstrate that providing rapid, accurate drug susceptibility information to physicians could improve the care of patients with sepsis[*], a potentially life-threatening condition caused by the body’s response to an infection.

According to Ritu Banerjee [childrenshospitalvanderbilt.org], MD, PhD, associate professor of Pediatrics at Monroe Carell Jr. Children’s Hospital at Vanderbilt [childrenshospitalvanderbilt.org], time is of the essence.

“Patients are placed on a standard course of antibiotics when they initially present with possible sepsis,” said Banerjee, the principal investigator of the RAPIDS-GN trial. “These antibiotics may be ineffective, or conversely, too broad-spectrum. Conventional culture and susceptibility testing methods take days for results to identify the bacteria and drug resistance.

[...]Banerjee and her colleagues sought a way to shorten the wait time until the appropriate medication could be started to treat the infection.

RAPIDS-GN, is the first multicenter, prospective, randomized controlled trial to compare the outcomes of patients with Gram-negative bloodstream infections who had blood culture testing with standard-of- care culture and antibiotic susceptibility testing versus rapid organism identification and phenotype antibiotic susceptibility testing.

The study looked at the outcomes of 448 patients — 226 received conventional care while 222 were randomized to the new testing method.

[...]“The time to results was significantly shorter,” said Banerjee. “The median time to the first antibiotic change was 24 hours faster in the rapid testing arm compared to the control arm. We can now tailor the antibiotics more quickly and place patients on pathogen-directed therapy rather than broad-spectrum, empiric therapy.

[...]“One of the challenges is the cost of the testing, because rapid testing methods are more expensive than conventional methods,” she said. “The overarching goal is to improve outcomes for patients with sepsis.”

[*] Sepsis [wikipedia.org]:

Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs.

[...]Sepsis is caused by an inflammatory immune response triggered by an infection. Most commonly, the infection is bacterial, but it may also be fungal, viral, or protozoan.

[...]Disease severity partly determines the outcome. The risk of death from sepsis is as high as 30%, from severe sepsis as high as 50%, and from septic shock as high as 80%.

Any cut or injury that turns red and starts to emit pus is a sign of infection that could, in turn, lead to sepsis. Be sure to seek out medical help if you are at all unsure.


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