An interdisciplinary infectious disease support team with longitudinal process interventions is associated with lower...

We aimed to evaluate the impact of transitioning from a conventional antimicrobial stewardship team (AST) to an interdisciplinary infectious disease support team (IDST) on patient mortality.

Single-center retrospective cohort study.

Yamanashi Prefectural Central Hospital.

We included patients with bacteremia during the AST and IDST periods.

We implemented an interdisciplinary IDST that provided comprehensive support beyond antimicrobial selection and treatment. We compared 28-day mortality outcomes in hospitalized patients with bacteremia during the AST-only period (April 2021-March 2022) and the IDST-intervention period (April 2022-March 2023). Cox proportional hazards modeling was used to assess 28-day mortality; multivariable logistic regression served as a prespecified sensitivity analysis. Between-group differences were tested using two-sided tests (P < .05), and 95% confidence intervals (CIs) were reported.

Among the 854 patients (413 in the AST group and 441 in the IDST group), AST interventions did not significantly decrease 28-day mortality compared with no-intervention cases (20.8% vs 23.3%, P = .630). However, intervention by the IDST significantly reduced 28-day mortality compared with the no-IDST group (16.1% vs 25.2%, P = .019). In the multivariate Cox proportional hazards model, IDST interventions remained independently associated with a reduced 28-day mortality (hazard ratio, 0.518; 95% CI, 0.325-0.826; P = .006).

Transitioning from an AST to an interdisciplinary IDST model was associated with lower 28-day mortality in bacteremia cases, possibly due to sustained diagnostic and therapeutic interventions. Our findings support stewardship as a team-based process and may significantly impact patient outcomes by maintaining involvement until treatment completion and clinical stabilization.