QJM Advance Access originally published online on September 19, 2008
QJM 2008 101(11):889-898; doi:10.1093/qjmed/hcn114
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Development, impact and outcomes of the Hull Bacteraemia Service
From the 1Department of Infection and Tropical Medicine, 2Department of Medical Microbiology and 3Department of Pharmacy, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
Address correspondence to Dr Gavin Barlow, Department of Infection and Tropical Medicine, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS trust, Cottingham, East Yorkshire HU16 5JQ, UK. email: gavin.barlow{at}hey.nhs.uk
Received 3 July 2008 and in revised form 19 August 2008
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Abstract |
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Background: Bacteraemia is a significant cause of mortality and healthcare expenditure. Evidence suggests that consultation by an infection specialist may improve outcomes.
Aim: To review the characteristics and outcomes of patients seen by a newly implemented bacteraemia service.
Methods: Retrospective review of data collected at time of consultation. Economic analyses and benchmarking of outcomes were also performed.
Results: One hundred and fifty-one patients were seen by the service over an 18-month period. Staphylococcus aureus was the most common isolate and central venous lines the most common source. Antibiotics were changed and additional investigations suggested in 62% and 61% of patients, respectively. The 30-day mortality was 19%. Implementation and delivery of the service over the 18-month study period cost £22 663 (£15 109 per year). The cost per change in antibiotic prescription was £244. The cost per ‘near-miss’ detected was £1193. Overall mortality was no higher and possibly lower than in published studies.
Conclusion: We believe that this model of care may be suitable for the management of patients with bacteraemia. A study assessing the cost-effectiveness of this approach is required.