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Review
. 2023 Feb 20:12:2022-9-5.
doi: 10.7573/dic.2022-9-5. eCollection 2023.

Leveraging diagnostic stewardship within antimicrobial stewardship programmes

Kimberly C Claeys  1 , Melissa D Johnson  2   3
Affiliations
Review

Leveraging diagnostic stewardship within antimicrobial stewardship programmes

Kimberly C Claeys et al. Drugs Context. .

Abstract

Novel diagnostic stewardship in infectious disease consists of interventions that modify ordering, processing, and reporting of diagnostic tests to provide the right test for the right patient, prompting the right action. The interventions work upstream and synergistically with traditional antimicrobial stewardship efforts. As diagnostic stewardship continues to gain public attention, it is critical that antimicrobial stewardship programmes not only learn how to effectively leverage diagnostic testing to improve antimicrobial use but also ensure that they are stakeholders and leaders in developing new diagnostic stewardship interventions within their institutions. This review will discuss the need for diagnostic and antimicrobial stewardship, the interplay of diagnostic and antimicrobial stewardship, evidence of benefit to antimicrobial stewardship programmes, and considerations for successfully engaging in diagnostic stewardship interventions. This article is part of the Antibiotic stewardship Special Issue: https://www.drugsincontext.com/special_issues/antimicrobial-stewardship-a-focus-on-the-need-for-moderation.

Keywords: antimicrobial stewardship; diagnostic stewardship.

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Conflict of interest statement

Disclosure and potential conflicts of interest: KCC reports speaking and service for bioMérieux, research funding from Centers from Disease Control and Prevention and Merck & Co. KCC has served on advisory boards for bioMérieux, Melinta Therapeutics, La Jolla Pharmaceuticals and AbbVie. MDJ has received consulting fees from Astellas, Cidara, Merck, Entasis, Paratek, Pfizer and Theratechnologies, author royalties from UpToDate, and research grants to her institution from Astellas, Scynexis, Charles River Laboratories and Merck & Co, and has served on the Board of the Society of Infectious Diseases Pharmacists. She also has a patent pending for gene expression–based classifiers of fungal infection. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2023/01/dic.2022-9-5-COI.pdf

Figures

Figure 1
Figure 1
Relationship between diagnostic and antimicrobial stewardship.
Figure 2
Figure 2. Evidence-based diagnostic stewardship examples impacting antimicrobial use
AST, automated susceptibility testing; CCDS, computerized clinical decision support; CDI, C. difficile infection; ID/AMs, Infectious Diseases/Antimicrobial Stewardship; NAAT, Nucleic Acid Amplification Test; PCT, procalcitonin; RDT, rapid diagnostic testing; RVP, respiratory viral panel; UA, urinalysis; UTI, urinary tract infection
See this image and copyright information in PMC

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