Abstract
BACKGROUND: Moderate-risk ampC beta-lactamase-producing Enterobacterales (HECK-Yes organisms) render many beta-lactams ineffective. OBJECTIVE: This study evaluates selective reporting (SR) of antimicrobial susceptibility testing (AST) results to improve antibiotic prescribing for these infections. DESIGN: A retrospective quasi-experimental study evaluating patients before and after the implementation of SR. METHODS: SR of AST results for HECK-Yes organisms was implemented at a 1500-bed medical center. A retrospective study compared antibiotic prescribing before and after implementation in patients with positive blood or respiratory cultures. RESULTS: Fifty patients were included in both pre- and post-implementation groups with similar baseline characteristics. Post-implementation, appropriate antibiotics within 24 h of AST report increased by 24% (62% pre vs 86% post, p = 0.01). A total of 30-day mortality, clinical success, and microbiological failure rates were similar between groups. CONCLUSION: SR improved appropriate antibiotic prescribing for moderate-risk ampC-producing Enterobacterales (e.g., HECK-Yes) infections.