Using Rapid Diagnostic Testing to Streamline Therapy for Candida Fungemia

This is a before-after study forwarded to me by one of my pharmacy colleagues looking at the effects of using peptide nucleic acid fluorescence in situ hybridization (PNA FISH) technology to rapidly identify Candida species in conjunction with a protocol via which on-call pharmacists then made real-time recommendations to providers according to a pre-determined stewardship program protocol. The authors found that the time to Candida species identification was much faster in the PNA FISH group (0.2 versus 4 days, p < 0.01), and the time to targeted antifungal therapy was significantly reduced, as well. There was no significant difference in hospital length of stay or mortality; actual costs were not measured although the authors postulate a cost savings of over $400.

This is a nice example of how rapid diagnostic testing, when used in conjunction with an antibiotic stewardship program, can lead to rapid antimicrobial narrowing/ streamlining.