Selective reporting of antibiotic susceptibility testing results: a retrospective evaluation of a nudging strategy to improve antibiotic prescribing for ampC-producing infections in hospitalized adults

Background: Moderate-risk ampC beta-lactamase-producing Enterobacterales (HECK-Yes organisms) render many beta-lactams ineffective. Objective: This study evaluates selective reporting (SR) of antimicrobial susceptibility testing (AST) results to improve antibiotic prescribing for these infections. D...

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Main Authors: Andy Lim, Terrence McSweeney, Phyu M. Thwe, Mei H. Chang, Hongkai Bao, Philip Lee, Kelsie Cowman, Priya Nori, Yi Guo
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Therapeutic Advances in Infectious Disease
Online Access:https://doi.org/10.1177/20499361251338017
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Summary:Background: Moderate-risk ampC beta-lactamase-producing Enterobacterales (HECK-Yes organisms) render many beta-lactams ineffective. Objective: This study evaluates selective reporting (SR) of antimicrobial susceptibility testing (AST) results to improve antibiotic prescribing for these infections. Design: A retrospective quasi-experimental study evaluating patients before and after the implementation of SR. Methods: SR of AST results for HECK-Yes organisms was implemented at a 1500-bed medical center. A retrospective study compared antibiotic prescribing before and after implementation in patients with positive blood or respiratory cultures. Results: Fifty patients were included in both pre- and post-implementation groups with similar baseline characteristics. Post-implementation, appropriate antibiotics within 24 h of AST report increased by 24% (62% pre vs 86% post, p  = 0.01). A total of 30-day mortality, clinical success, and microbiological failure rates were similar between groups. Conclusion: SR improved appropriate antibiotic prescribing for moderate-risk ampC-producing Enterobacterales (e.g., HECK-Yes) infections.
ISSN:2049-937X