BMJ  2008;336:521 (8 March), doi:10.1136/bmj.39507.455567.80

Letters

Bloodstream infection

Bacteraemia service model of infection care

The first 150 words of the full text of this article appear below.

In June 2005 we implemented a similar service to Minton et al’s,1 which provides unsolicited bedside reviews and a typewritten report for all patients with bacteraemia. We reviewed 151 adults from June 2005 to November 2006.

The most common isolate was Staphylococcus aureus (45%), of which 40% were methicillin resistant; the most common source was central venous lines (27% of patients). For hospital acquired bacteraemia, therefore, the report is now sent to the trust’s medical director and forms part of the root cause analysis.

Our pre-consultation level of appropriateness of antibiotic prescriptions was high (87%)—perhaps because of an accessible and well recognised trust-wide antibiotic guideline—but 62% of cases still needed optimisation at review. After consultation, prescriptions for broad spectrum agents decreased from 41 to 24, whereas those for intermediate spectrum (58 to 68) and narrow spectrum antibiotics (81 to 87) increased. Further investigations were suggested in 60% of patients. We . . . [Full text of this article]

Gavin D Barlow, consultant in infectious diseases/medicine1, Patrick Lillie, specialist registrar in infectious diseases/medicine2

1 Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Cottingham, East Yorkshire HU16 5JQ, 2 Royal Hallamshire Hospital, Sheffield S10 2FJ

gavin.barlow@hey.nhs.uk


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Relevant Article

Improving early management of bloodstream infection: a quality improvement project
Jane Minton, James Clayton, Jonathan Sandoe, Hugh Mc Gann, and Mark Wilcox
BMJ 2008 336: 440-443. [Extract] [Full Text] [PDF]

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