2026 Volume 41 Issue 1 Pages 35-43
Staphylococcus aureus bacteremia (SAB) is a serious bloodstream infection. The early administration of appropriate antibiotics based on the causative bacteria is essential. This retrospective study used the Xpert MRSA/SA BC test to evaluate the impact of pharmacist-led antimicrobial stewardship on antimicrobial use patterns and treatment outcomes. From September 2022 to April 2025, 77 hospitalized patients of ≥18 years of age diagnosed with SAB at our institution were included. Patients were divided into two groups: 42 before and 35 after the implementation of Xpert. Propensity score matching was used to compare the 21 patients in each group. In the post-implementation group, the time to initiation of appropriate antimicrobial therapy was significantly shorter (median: 17.0 h [interquartile range (IQR): 3.0-64.0] vs. 2.0 h [IQR: 1.0-23.0]; p < 0.05). In addition, the proportion of patients receiving appropriate antibiotics within 48 h was higher (66.7% vs. 100.0%; p < 0.05). The unnecessary use of anti-MRSA agents was significantly reduced among patients with methicillin-susceptible SAB (31.2% vs. 93.3%; p < 0.001). By contrast, no significant difference was observed in the primary endpoint of 30-day all-cause mortality between the two groups (19.0% vs. 19.0%, p = 1.00). Xpert MRSA/SA BC has shown potential for facilitating the timely administration of appropriate antibiotics and avoiding unnecessary anti-MRSA drugs in cases of SAB, even when led by pharmacists.
