Electronic prompt for blood culture collection
Abstract:
Background: Sampling blood cultures before administering antibiotics is essential for diagnosis and treatment of infections. Antimicrobial stewardship team (AST) monitor broad-spectrum antibiotics and anti-meticillin-resistant Staphylococcus aureus (MRSA) agents and these antibiotics are managed by the notification system at many hospitals in Japan. However, there are few reports on interventions by AST pharmacists to improve the rate of blood culture sampling. This study aimed to evaluate the effect of recommendations on blood culture sampling by an AST pharmacist.
Methods: We monitored all hospitalized patients prescribed alert antibiotics (intravenous broad-spectrum antibiotics and anti-MRSA agents) and we assessed the indication. The AST pharmacist began verifying whether blood cultures had been obtained in April 2023. If blood cultures had not been collected, the pharmacist manually recorded a prompt in the patient’s electronic medical record recommending the collection of two sets of blood cultures. We compared the change of compliance with prescribed alert antibiotics and collecting blood culture sets between the baseline period (April 2022 to March 2023) and intervention period (April 2023 to March 2024) using Mann-Whitney U test.
Results: The rate of blood culture sampling pre-alert antibiotics administration increased significantly (44.6% vs. 51.9%, p < 0.05) without increasing the contamination rate and as a secondary effect, the prescription of alert antibiotics decreased (15.6 vs. 13.2, p < 0.05) after the AST pharmacist's recommendations.
Conclusions: The recommendations to physicians of blood culture sampling by an AST pharmacist may improve the rate of blood culture sampling and decrease the prescription of alert antibiotics.
Reference:
Shibata Y, Asai N, Hagihara M, Mikamo H. Effect of an electronic prompt for blood culture collection in patients on broad-spectrum antibiotics (an initiative of the antimicrobial stewardship team pharmacist). J Hosp Infect. 2025 Nov 19:S0195-6701(25)00368-8. doi: 10.1016/j.jhin.2025.11.012. Epub ahead of print. PMID: 41271167.