Delays in starting antibiotics for bacteremia can be significant. One community teaching hospital implemented a protocol to notify a pharmacist whenever a blood culture turned positive so appropriate therapy could be started faster and infection-related mortality dropped from 25% to 11%.
The protocol is called the rapid administration of antimicrobials by an infectious diseases specialist (RAIDS) protocol. It is a very simple design. When a blood culture turns positive, an infectious disease pharmacist is called by the microbiology lab. This pharmacist reviews current antibiotic orders, calls the appropriate physician, takes an order if antibiotics need to be changed, and hand-delivers the antibiotic to the patient’s nurse at the bedside.
In addition to the infection-related mortality decrease, implementation of this protocol brought the time to first antibiotic dose for new bacteremia down from over 9 hours to 1 hour and 23 minutes.
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