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The Value of AMS Efforts in Ambulatory and Emergency Settings

Antimicrobial stewardship (AMS) is an important part of healthcare, and its value is especially evident in ambulatory settings and emergency room departments. AMS is the practice of using antimicrobials responsibly—ensuring they are prescribed only when necessary and in the most effective way possible. This practice is essential in ambulatory and emergency room departments, as these departments are often the first point of contact for patients with infectious diseases and can therefore have a large impact on AMS efforts.

Antimicrobial Overuse in Ambulatory and Emergency Settings

Emergency rooms and outpatient settings are often the first points of contact for patients with infectious diseases, and it is important to ensure that antibiotics are used appropriately. But, with the rush of patients and the sheer volume of people that come into and out of the emergency room or ambulatory clinics, prescribing the correct antibiotics in a timely manner can be a challenge.

According to the Centers for Disease Control (CDC), “Antibiotics can save lives, but any time antibiotics are used, they can cause side effects and contribute to the development of antibiotic resistance. In U.S. doctors’ offices and emergency departments, at least 28% of antibiotic courses prescribed each year are unnecessary, which makes improving antibiotic prescribing and use a national priority.”1

Ambulatory and outpatient settings also see high levels of inappropriate antibiotic use:

  • “Total inappropriate antibiotic use, inclusive of unnecessary use and inappropriate selection, dosing, and duration, may approach 50% of all outpatient antibiotic use.”2
  • “An estimated 80–90% of the volume of human antibiotic use occurs in the outpatient setting.”2

This level of antimicrobial prescribing means that antimicrobial stewardship efforts can make a real difference in ambulatory settings and the emergency department.

The Role of Diagnostics in Antimicrobial Stewardship

Fast diagnostics are essential in ambulatory and emergency department settings. Fast diagnostics can help reduce the time it takes to diagnose a patient and get them on appropriate therapy. Additionally, fast diagnostics can help clinicians make decisions regarding admissions and discharges and can help avoid the use of unnecessary antimicrobials, de-escalate broad-spectrum antimicrobials, and get patients on optimal therapy quickly.

The Syndromic Approach

Using multiplex polymerase chain reaction (PCR) technology, bioMérieux sets the standard for syndromic testing. The syndromic approach combines a comprehensive grouping of probable pathogens into one, quick PCR test, maximizing the chance of getting an actionable answer in a clinically relevant timeframe.

Traditionally, identifying a bacterial infection depends on growing the organism in culture, which can be slow and sometimes even ineffective. Multiplex PCR testing can detect bacteria in a sample in about an hour—instead of days—giving patients quick and fast answers that can help in timely diagnosis and appropriate treatment.

The syndromic approach is a valuable tool for helping emergency rooms and other ambulatory settings with their AMS efforts by enabling a quick diagnosis and timely treatment of the patient.

BIOFIRE Syndromic Testing

bioMérieux offers a portfolio of BIOFIRE syndromic testing solutions that provide the fast, actionable answers clinicians need to make optimal treatment decisions and avoid the unnecessary use of antimicrobials.

The BIOFIRE® RP2.1 Panel accurately detects and identifies the pathogens most associated with respiratory infections. This panel has a run time of about 45 minutes—which may enable better informed diagnosis and treatment of patients.

The BIOFIRE® FILMARRAY® Gastrointestinal (GI) Panel tests for 22 of the most common pathogens associated with gastroenteritis—all from one patient sample, with results available in about one hour.

The BIOFIRE® Joint Infection (JI) Panel tests for a comprehensive grouping of gram-positive and gram-negative bacteria, yeast, and antimicrobial resistance genes commonly associated with joint infections. It takes just one syndromic test, one small sample of synovial fluid, and about an hour to get results on 39 clinically relevant targets.

These are only a few of the syndromic panels included in the full BIOFIRE range. Learn more about the complete portfolio.

References

  1. CDC. Antibiotic Prescribing and Use. Accessed 01 Feb 2023. Retrieved from: https://www.cdc.gov/antibiotic-use/index.html
  2. Measuring Outpatient Antibiotic Prescribing. Accessed 01 Feb 2023. Retrieved from: https://www.cdc.gov/antibiotic-use/data/outpatient-prescribing/index.html

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