Stewardship: It’s not just for antimicrobials

An important part of using antimicrobials appropriately is ordering the right pathology tests.

Increasing workloads have been identified in pathology departments across Australia and pathology is a significant cost to the health system. While there is no Australian data it has been estimated that up to 25% of pathology ordered in the UK is either unnecessary or inappropriate.

As ordering the right test is one of our AIMED principles it was interesting to see a recent article looking at inappropriate microbiological tests.

Ozbug, an email based discussion site for the Australasian Society for Infectious Diseases, was asked “What microbiology laboratory investigation would you consider to be the one, although requested, results in least patient benefit? or What do you consider to be the most useless of microbiology tests?”. The results of the discussion are summarised here as published in the MJA.

The group identified tests that are often ordered inappropriately, factors contributing to the inappropriate ordering and strategies to improve the use of pathology resources. The results might surprise you.

Using our pathology resources appropriately is an important part of using antimicrobials appropriately. As a local example it is estimated that more that half of the gentamicin serum concentrations performed locally are inappropriate costing the health service over $13 000 a year! That would certainly add up.

One comment

  1. A response to this article has been published and is available here

    It contains useful links to pathology resources.


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