caa a22 4500 475831543 CHVBK 20180406123841.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1007/s100960000306 doi (NATIONALLICENCE)springer-10.1007/s100960000306 Clinical Impact of an Infectious Disease Service on the Management of Bloodstream Infection [Elektronische Daten] [U. Fluckiger, W. Zimmerli, H. Sax, R. Frei, A. F. Widmer]  The impact of an infectious disease (ID) service on the optimal antibiotic management of 103 patients with bloodstream infections, defined as bacteremia and systemic inflammatory response syndrome, was evaluated. The optimal antibiotic management was defined according to the Sanford Guide to Antimicrobial Therapy (1996) or written internal guidelines. The judgment on optimal antibiotic management was made at the time of reporting the positive blood culture results. Switching from a broad-spectrum to a narrow-spectrum agent was carried out significantly more often by the ID service than by the attending physicians (25 of 25 vs. 20 of 40;P<0.001). In patients without empirical therapy, the ID service initiated optimal antimicrobial therapy significantly more often than physicians without training in infectious diseases (12 of 12 vs. 4 of 10, P=0.0028). Three of 12 patients in whom the attending physician misinterpreted the positive blood culture result needed 8 days to 4 months of additional hospitalization. In summary, patients for whom an ID service was provided received appropriate treatment more often and experienced significantly fewer complications. Springer-Verlag Berlin Heidelberg, 2000 Fluckiger U. Division of Infectious Diseases and Clinical Epidemiology, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland e-mail: awidmer@uhbs.ch, CH aut Zimmerli W. Department of Internal Medicine, Liestal University Hospital, Switzerland, CH aut Sax H. Division of Infectious Diseases, Geneva University Hospital, 1211 Geneva 14, Switzerland, CH aut Frei R. Bacteriology Laboratory, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland, CH aut Widmer A. F. Division of Infectious Diseases and Clinical Epidemiology, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland e-mail: awidmer@uhbs.ch, CH aut https://doi.org/10.1007/s100960000306 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s100960000306 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fluckiger U. Division of Infectious Diseases and Clinical Epidemiology, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland e-mail: awidmer@uhbs.ch, CH aut NATIONALLICENCE 700 1- Zimmerli W. Department of Internal Medicine, Liestal University Hospital, Switzerland, CH aut NATIONALLICENCE 700 1- Sax H. Division of Infectious Diseases, Geneva University Hospital, 1211 Geneva 14, Switzerland, CH aut NATIONALLICENCE 700 1- Frei R. Bacteriology Laboratory, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland, CH aut NATIONALLICENCE 700 1- Widmer A. F. Division of Infectious Diseases and Clinical Epidemiology, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland e-mail: awidmer@uhbs.ch, CH aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer