Abstract Background Difficulty in determining the etiology of infections in the emergency department (ED) and urgent care (UC) settings often leads to suboptimal outcomes. MeMed BV® (MMBV) is an FDA-cleared host-protein test that differentiates bacterial and viral infections, with sensitivity and specificity 90% and negative predictive value 98%. This post hoc analysis evaluated whether alignment between MMBV and antibiotic prescribing improved outcomes. The hypothesis was that viral MMBV cases untreated with antibiotics have similar outcomes to those treated, while untreated bacterial cases have worse outcomes. We also estimated potential impact on costs. Alignment between antibiotic prescription and MeMed BV (MMBV) results and outcomes This project has been supported in part with federal funds from the Department of Health and Human Services; Administration for Strategic Preparedness and Response; Biomedical Advanced Research and Development Authority (BARDA), under contract number 75A50123C00041. Methods US adults (≥18) from 11 sites, with suspected acute infections from two prospective studies (NCT04690569, NCT05762302) were included. Only those discharged with complete follow-up were analyzed. MMBV scores range 0-100: 35 indicate a viral (or non-bacterial) infection, 35–65 is equivocal, and 65 indicates a bacterial infection (or co-infection). Based on MMBV’s validated accuracy, antibiotics were considered unwarranted for MMBV 35 and warranted for MMBV 65. Outcomes included unplanned ED/UC return visits and hospitalization in 28 days. Cost analysis used 2024 AHRQ Healthcare Cost 60% female, median age 36 years (IQR: 27-49), 48% ED enrollment. Patients with MMBV 35 (n=238) not prescribed antibiotics showed no significant difference in ED/UC return visits (5% vs. 4%; p=0. 947) or hospitalization (1% vs. 0%; p=0. 375) as compared to patients prescribed antibiotics. Patients with MMBV 65 (n=53) not prescribed antibiotics had significantly more ED/UC return visits (20% vs. 3%; p=0. 042) and increased hospitalization (10% vs. 0%; p=0. 067) as compared to patients prescribed antibiotics. In the MMBV-aligned group (n=204), there were 9 return visits, 2 hospitalizations, and 4 hospital days, costing 16, 611 (81/patient). In the non-aligned group (n=87), there were 7 return visits, 2 hospitalizations, and 31 hospital days, costing 73, 327 (843/patient), providing 761/patient savings with MMBV alignment. Conclusion Alignment between antibiotic prescribing and MMBV results is associated with better patient outcomes and lower hospital costs. Disclosures Lior Kellerman, M. D, MeMed Diagnostic: Employee Tanya Gottlieb, PhD, MeMed Diagnostic: Employee Boris Lebedenko, MSc, MeMed Diagnostic: Employee Roy Navon, MSc, MeMed Diagnostic: Employee Brian DuChateau, PhD, MeMed Diagnostic: Employee Gabriel A. Bien-Willner, MD, PhD, FCAP, MeMed Diagnostic: Advisor/Consultant
Kellerman et al. (Thu,) studied this question.