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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
Opportunities for antimicrobial susceptibility testing contribution to antimicrobial stewardship |
| Language |
J |
| AuthorList |
Sho Nishimura |
| Affiliation |
Hyogo prefectural Harima-Himeji general medical center |
| Publication |
J.J.C.M.: 34 (1), 1-17, 2023 |
| Received |
September 24, 2023 |
| Accepted |
|
| Abstract |
Although physicians and pharmacists are generally seen as taking the initiative in antimicrobial stewardship, clinical laboratory technicians actually play a major role in the process. This is because accurate microbiological diagnosis is indispensable for facilitating this interdisciplinary effort. Among the various microbiological tests, antimicrobial susceptibility testing has the greatest impact on the selection of antimicrobials. Rapid diagnostic tests (RDTs) based on molecular diagnosis, including that of antimicrobial resistance gene sequences, have advanced remarkably in recent years. However, conventional phenotypic antimicrobial susceptibility testing is still indispensable, especially for gram-negative rods, the antimicrobial resistance of which could involve multiple resistance mechanisms. Because definitive therapy is difficult to determine without the results of phenotypic antimicrobial susceptibility testing, clinical laboratory technicians are required to perform accurate and rapid drug susceptibility testing. Additionally, clinicians typically have difficulty in interpreting RDT results, and such tests can only be useful if the results are translated into information that is accessible to clinicians and reported in a timely manner. Finally, the strategy used to report antimicrobial susceptibility testing results greatly affects the clinician's choice of antimicrobial agents. For example, reporting the results of unnecessary broad-spectrum antimicrobial susceptibilities increases the odds that a broad-spectrum antimicrobial will be selected. Although the clinician is ultimately responsible for selecting the antimicrobial agent, clinical laboratory technicians should be aware that they are partly responsible for influencing that decision. |
| Keywords |
selective reporting, diagnostic stewardship, rapid diagnostic test |
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