Antibiogram Directed Empirical Therapy

Empirical therapy may precede susceptibility test reporting by more than 48 hours and many antibiotic doses are ineffective. Successful patient outcomes are delayed leading to increased hospital stay and increased cost. Including antibiotics choices for empirical therapy on preliminary reports, based on antibiograms, was instituted for improved efficiency.

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Empirical therapy selection consists of physician guesses. Choosing antibiotics for empirical therapy according to presumptively identified organisms, source, and percent susceptibility, was selected. The choices are indicated on preliminary reports ( enclosed ) as good empirical therapy choices if percent susceptibility was equal to or greater than 90 percent.

Possible ineffective empirical therapy choices were indicated if percent susceptibility was less than 70 percent; three or more antibiotics are indicated for each choice when possible. Antibiotics that can be administered orally are listed first.

Each antibiogram intrepation consists of at least 100 isolates furnished by our Microscan WalkAway 40 instrument. Antibiogram data is tabulated as shown for selecting empirical choices.

Preliminary reports with antibiotic choices on each report is appreciated by our physicians. Moreover, empirical therapy with scientific basis has improved patient outcomes substantially. For example, patients formerly given ineffective antibiotics empirically now receive an antibiotic(s) with greater than 90 percent predicted susceptibility; antibiotic changes after susceptibility test reporting are greatly reduced.

Physicians previously utilized complex computer generated copies of our antibiograms for empirical therapy selection. Presently, preliminary reports indicating antibiotic choices are available in patient records when empirical therapy is required.

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