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Impact of hemo-alert program on appropriate antimicrobial therapy in hospitalized patients with bacteremia: a
Siwakan Phuetphaichit1, Surangkana Samanloh2, Witchuda Kamolvit3
1Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Objectives:
To evaluate the impact of the HemoAlert program-a notification system providing pathogen identification and antimicrobial susceptibility results-on the time to initiation of appropriate antimicrobial therapy in patients with bacteremia.
Design:
Pre-post-quasi-experimental study.
Setting:
Siriraj Hospital, the largest tertiary care hospital in Bangkok, Thailand.
Patients:
Adult hospitalized patients with at least one positive blood culture between December 2021-February 2022.
Methods:
A quasi-experimental study was conducted to assess the impact of the HemoAlert program, which delivered SMS notifications of final microbiology results to the responsible physician and updated the patient's medical record. The primary outcome was the time to appropriate antimicrobial therapy. Secondary outcomes included appropriateness of antimicrobial therapy at 72 and 120 hours, favorable clinical outcome, 28-day mortality, and length of hospital stay.
Results:
A total of 150 patients were included in both periods. Demographics and pathogen distribution were similar between groups. The most common pathogens were Escherichia coli, followed by Klebsiella pneumoniae, and Staphylococcus aureus. The postimplementation group also showed a trend toward a shorter time to appropriate antimicrobial therapy (81.38 ± 61.38 vs 66.17 ± 51.81 h; P = .08). Patients in the postimplementation group were more likely to receive appropriate therapy within the first 72 hours (34.0% vs 22.7%; P = .03). Favorable clinical response was more frequent after implementation (74.0% vs 85.3%; P = .02), whereas 28-day mortality was similar (24.0% vs 18.0%; P = .20).
Conclusion:
The HemoAlert program improved the timeliness and appropriateness of antimicrobial therapy and enhanced clinical response in patients with bacteremia, supporting the utility of simple notification systems in optimizing management.
