b'Chapter 7 How to approach antimicrobial stewardship after COVID-19An interview with Elizabeth Palavecino, MDDuring the worst of the pandemic, clinicians threw everythingHow have advances in molecular testing changed the at COVID-19 to try to save patient lives. That often includedapproach to ASPs?antibiotics. About 80% of patients hospitalized with COVID-19There is no doubt that molecular testing has improved received antibiotics between March 2020 and October 2020,antimicrobial stewardship. In our institution, when we started according to the Centers for Disease Control and Preventiondoing more molecular testing, we saw the impact of having (CDC), even though fewer than 3% of patients showed any signresults available to the clinicians much faster. They can decide on of a bacterial infection [1]. The CDC noted this was likely due toa therapy at almost the same time they are seeing patients.difficulties distinguishing COVID-19 from community-acquired pneumonia when patients first arrived at a hospital. In addition,We implemented the use of a multiplex panel for detection of critically ill patients might have been treated for bacterialorganisms from positive blood cultures on a specific group of co-infections. patients: those admitted to the hospital, especially the intensive care unit (ICU). The results were available shortly after growth CDC is now devoting millions of dollars for local healthwas detected in the blood culture bottles 7 days a week, departments to tamp down on improper antibiotic prescribing,24 hours a day.including $120 million to departments in New York City, Los Angeles County, and 60 other jurisdictions, according toOf course, if you send a result at 2:00 a.m., you really need Bloomberg Law. somebody on the clinical side to evaluate the report and make a treatment decision. If the lab sent the result to the ICU, there was Laboratory medicine professionals play a crucial role inalways a clinician available there who could make a therapeutic antimicrobial stewardship programs (ASPs), and in ensuringdecision. Thats why, at the beginning, we focused primarily on appropriate antibiotic use. We spoke to Elizabeth Palavecino,those patients who could benefit the most. In our hospital, the MD, professor of pathology at the Wake Forest University Schooluse of rapid molecular testing from positive blood culture has led of Medicine, about changes shes seen in ASP throughout herto rapid diagnosis and appropriate treatment of bacteremia.career, especially during the COVID-19 pandemic.This interview has been edited for space and clarity.23 Molecular testing thermofisher.com/infectiousdisease Contents'