Rapid diagnostic testing (RDT) combined with an antimicrobial stewardship program (ASP) has shown improved outcomes in bloodstream infections (BSIs). We assessed the impact of RDT, surveillance software, and ASP pharmacist staffing on time to optimal therapy (TOT) in Gram-negative BSIs. Adults with Gram-negative BSIs were included in this retrospective evaluation across 2 study periods. The preimplementation group (n = 121) had longer TOT than the postimplementation group (n = 120) (59.6 ± 36.2 h versus 29.0 ± 24.2 h, P < 0.001). Escalation (51.1 ± 26.4 h versus 16.9 ± 15.7 h, P < 0.001) and de-escalation (63.1 ± 39.5 h versus 39.2 ± 25.6 h, P < 0.01) of therapy were shorter in the postimplementation group. TOT for patients with multidrug-resistant organisms (MDROs) was shorter in the postimplementation group (61.8 ± 37.2 h versus 21.9 ± 18.8 h, P < 0.001). TOT was shorter during fully staffed clinical pharmacist hours (30.6 ± 58.9 h versus 19.7 ± 31.7 h, p = 0.014). Implementation of RDT and surveillance software with an ASP decreased TOT for Gram-negative BSIs, including MDROs.

快速诊断测试（RDT）结合抗菌素管理计划（ASP）已显示出血液感染（BSI）的改善结果。我们评估了RDT，监控软件和ASP药剂师人员配置对革兰氏阴性BSI达到最佳治疗（TOT）时间的影响。回顾性评估包括2个研究阶段的革兰阴性BSI成人。实施前组（n  = 121）比实施后组（n  = 120）更长（59.6±36.2 h对29.0±24.2 h，P  <0.001）。升级（51.1±26.4 h与16.9±15.7 h，P  <0.001）和降级（63.1±39.5 h与39.2±25.6 h，P 在实施后组中，<0.01）的治疗时间较短。在实施后的组中，具有多重耐药性有机体（MDRO）的患者的TOT较短（61.8±37.2 h对21.9±18.8 h，P  <0.001）。在配备人员的临床药剂师时间内，TOT较短（30.6±58.9 h对19.7±31.7 h，p = 0.014）。使用ASP的RDT和监视软件的实施降低了包括MDRO在内的革兰氏阴性BSI的TOT。