Making the Case for Early ID Specialist Involvement

Making the Case for Early ID Specialist Involvement

In hospital settings, specialists are often consulted when managing patients with complex conditions, offering evidence-based recommendations on diagnosis and treatment plans. Infectious disease (ID) specialists are typically consulted when patients have one or more infectious conditions that are severe and require intensive monitoring. “ID specialists can assist hospitals in the inpatient setting by recommending appropriate antibiotic choices, duration of therapy, and route of delivery,” says Steven K. Schmitt, MD. “They can also help monitor patients to minimize adverse drug reactions.” Studies indicate that when an ID specialist is involved in patient care and the physician in charge follows ID recommendations, patients are more likely to receive a correct diagnosis. ID specialist involvement has also been associated with shorter lengths of stay (LOS), receipt of more appropriate therapies, fewer complications, and reduced use of antibiotics overall. However, data regarding the impact of ID specialists on hospital LOS and costs have been mixed. Many studies have been constrained by small sample size and chart review methodology, which limits the ability to generalize conclusions. As a result, it has been difficult to draw meaningful conclusions about the value of ID specialty interventions. Robust Data In a study published in Clinical Infectious Diseases, Dr. Schmitt and colleagues sought to generate robust data on the impact of ID consultation on spending and outcomes using a national Medicare claims database. Researchers looked at patients hospitalized with at least one of 11 serious but commonly treated infections. These included bacteremia, Clostridium difficile, central line-associated bloodstream infections, bacterial endocarditis, HIV/opportunistic infections, meningitis, osteomyelitis, prosthetic joint infections, septic arthritis, septic shock, and vascular device infections. Outcomes of a...

Combination Therapy Improves Meningitis Outcomes

Among HIV patients with cryptococcal meningitis, therapy with amphotericin B plus flucytosine appears to improve survival when compared with using amphotericin B alone. The combination was also associated with significantly higher rates of yeast clearance from cerebrospinal fluid. Abstract: New England Journal of Medicine, April 4,...