Impact of Rapid Antimicrobial Sensitivity Testing on Antibiotic Use and Outcomes in Bloodstream Infection Patients A Randomized Adaptive Trial

What this Trial Is About

Researchers are evaluating the use of Rapid Antimicrobial Susceptibility Testing R-AST tools compared to the current standard of care in patients with bloodstream infections BSI. The goal is to determine if early targeted antibiotic prescriptions guided by these rapid tests can improve antibiotic use and patient outcomes. This adaptive clinical trial platform allows ongoing evaluation of various R-AST technologies to identify the most effective diagnostic strategies efficiently. Participants are randomly assigned to one of two groups the experimental arm, where blood cultures are tested with R-AST tools providing rapid susceptibility data, and the standard care arm, where cultures follow the usual laboratory workflow. In both groups, test results are shared with treating clinicians who adjust antibiotic therapy accordingly. The trial design permits adjustments in randomization ratios and inclusion of new diagnostic tools over time. Participants are monitored for 28 days to assess clinical outcomes and antibiotic stewardship goals. The study involves standard microbiology cultures and susceptibility testing, with results typically available within 48 to 72 hours. Outcome assessors remain blinded to group assignments to ensure unbiased evaluation. The trial supports continuous innovation by allowing integration of additional R-AST methods in the future.

The Impact of Fast Antimicrobial Sensitivity Testing Tools on Stewardship Antibiotic and Clinical Outcome (ACT-FAST)