Therapy: the microbiologist's view.

Potentially, the clinical microbiologist is able to influence empirical and definitive therapy of bacteraemia. Definitive therapy of the individual can only be affected after the results of routine culture and sensitivity tests are available. Some so-called ‘rapid’ laboratory techniques enable early identification and sensitivity testing of isolates from blood cultures. Empirical therapy is more difficult to influence, with microbiologists relying on epidemiologically based education of the prescriber or encouragement of him to seek advice at an early stage. Newer, truly rapid methods that do not rely on culture may come to have an impact on individual empirical therapy. Microbiologists acquire information upon which to base their recommendations by a variety of local surveillance measures, from the published literature and (particularly for organisms of infection control significance) through professional contacts with their colleagues in other hospitals. Influence may be exerted on clinicians by direct contact, through manipulation of the content of laboratory reports, or by regular circulation of locally-collected summary data. The assessment of the real impact on bacteraemia of blood culture techniques and microbiological advice is in its infancy, but new data collection and handling methods make this an achievable ideal. [ABSTRACT FROM PUBLISHER]