To Curb Antibacterial Use for Suspected Sepsis, Consider an Opt-Out Discussion

In a randomized study, fewer patients in the opt-out intervention arm compared with the usual-care arm remained on antibacterials, although overall time on antibacterials did not differ.

While prompt use of empiric antibacterials for suspected sepsis can be beneficial, the practice may also have negative consequences. In such situations, reviewing antibacterial use daily has been recommended to enable narrowing or stopping therapy. An opt-out discussion is a tool to facilitate this process. The DETOURS trial, sponsored by the CDC Prevention Epicenters Program, was performed in 10 U.S. acute care hospitals from September 2018 through May 2020. Patients were included if they passed a screen indicating that de-escalating antibacterials would be safe; they were then randomized to usual care or an opt-out discussion between their clinician and an onsite clinical pharmacist. If the clinician opted out of the protocol and determin…

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

To Curb Antibacterial Use for Suspected Sepsis, Consider an Opt-Out Discussion

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Reviewing Author