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To minimize broad-spectrum antibiotic use, our microbiology laboratory changed antibiotic susceptibility reporting for AmpC-beta-lactamase producing  Serratia marcescens  and  Morganella morganii  in blood cultures to include results of narrow spectrum 3rd generation cephalosporins. We assessed the impact of this change on broad-spectrum antibiotic use and clinical outcomes. All adult patients with  Serratia marcescens  or  Morganella morganii  in blood culture 2 years pre- and post-change of susceptibility reporting were retrospectively reviewed. Exclusion: more than one pathogen isolated in their blood culture, did not receive antibiotics or died within 48 hours of positive blood culture. Outcomes: Rates of broad-spectrum antibiotic use, in-hospital mortality, clinical response and microbiologic success. There were 30 patients pre-change and 46 patients post-change of reporting. Cefepime use (broad-spectrum) decreased from 46.7% to 6.5% (p &lt; 0.001) and 3 rd  generation cephalosporin (narrow-spectrum) use increased (3.3% vs 34.8%, p = 0.0013) in the post-change cohort. This demonstrates the potential role of selective susceptibility reporting in antimicrobial stewardship.

Impact of antibiotic susceptibility reporting on broad spectrum antibiotic use in serratia and morganella bacteremia