Pharmacist

Guide appropriate and effective antibiotic selection and reduce unneeded drug use.

Scenario 1 - S. aureus Bloodstream Infection or Blood Culture Contamination?

The microbiology lab reports Gram-positive cocci in clusters (GPCC) in a patient's positive blood culture. How long does it take to know that the GPCC is S. aureus or even MRSA that represents true infection and requires aggressive therapy with vancomycin, linezolid or daptomycin? Conversely, how long does it take to know that the GPCC is a coagulase negative staphylococci (CNS) contaminant and does not require therapy? How is the patient treated in the meantime?

Scenario 2 - VRE Bloodstream Infection

The microbiology lab reports Gram-positive cocci in chains and pairs (GPCPC) in a patient's positive blood culture. How long does it take to know that the GPCC is E. faecalis that most likely can be treated with ampicillin? Or, the GPCPC is another enterococci such as E. faecium that is very likely vancomycin-resistant (VRE) and should receive neither vancomycin nor ampicillin, but perhaps linezolid? Or, the GPCPC is likely a Streptococcus? How is the patient treated in the meantime?

Scenario 3 - Antifungal Selection for Candidemia

The microbiology lab reports Yeast in a patient's positive blood culture. How long does it take to know that the Yeast is C. albicans and can be treated with either IV or PO fluconazole? Or, the Yeast is a non-C. albicans species such as C. glabrata, C. parapsilosis, C. dubliniensis or C. krusei that may require therapy with an echinocandin such as caspofungin or micafungin? How is the patient treated in the meantime?

For hospital pharmacists, rapid and accurate lab results are critical for optimizing antibiotic therapy for treating patients with infection. A delay in results can lead to broad coverage with agents that may be less effective, toxic, or expensive.¹ Ineffective and inappropriate therapy can result in:

Opportunity for Pharmacists

AdvanDx's molecular-based diagnostic products provide rapid identification of micro-organisms causing infections. Results are available within hours instead of days and help physicians and pharmacists improve therapy for their patients. By supporting the implementation of rapid diagnostics and playing an integral part of an effective antibiotic and patient management team, pharmacists can further tailor appropriate antibiotic therapy for the specific infection and thus improve antibiotic management, reduce unnecessary antibiotic use and maintain control over drug costs.

PNA FISH™ provides rapid identification of bacteria and yeast in positive blood cultures. The accurate results are available in hours instead of days and support appropriate therapy for patients with bloodstream infections. Studies show that implementing PNA FISH can result in:

EVIGENE™ provides rapid detection of antibiotic resistance and virulence markers in bacteria causing hospital and community acquired infections. The rapid results allow laboratories, physicians, pharmacists and infection control to better coordinate efforts to combat the spread of resistant and virulent bacteria and in turn improve both patient care and overall hospital operations.

Please see individual products for country specific regulatory status

1. Centers for Disease Control and Prevention: Campaign to Prevent Antimicrobial Resistance in Healthcare Settings. http://www.cdc.gov/drugresistance/healthcare/default.htm
2. Toombs et al. Impact of Peptide Nucleic Acid (PNA) Fluorescence in situ Hybridization (FISH) for Enterococcal blood stream infections. Oral Abstract #131, IDSA 2006 Annual Meeting, Toronto, Canada
3. Forrest et al. J Antimicrob Chemother. 2006 Jul;58(1):154-8
4. Forrest et al. J. Clin. Microbiol. 2006 44: 3381-3383.