3 ms·

But couldn’t a hospital use it only for the critical cases? Where it is immediately important to know what infection someone may have, at imminent risk of death

But couldn’t a hospital use it only for the critical cases? Where it is immediately important to know what infection someone may have, at imminent risk of death? Who cares if they need to charge $30k per patient to use it if that fast knowledge saves the patient’s life. It doesn’t need to fully replace the existing methods, but could be a useful supplement when a patient is in critical condition

Cthulhu_ 1y ago
Sure, but then they'd have a million(s) dollar machine (plus the people trained to operate it) waiting for these critical cases. It's a cost / benefit tradeoff, just like whether to use an MRI or CAT scan vs x-rays or an echo.
- passwordoops 1y ago
  Plus high-res mass specs can't just be turned on, they need to be kept on standby which isn't cheap when you cost it out over a year
mapt 1y ago
This is a false dichotomy. It doesn't have to be used for every patient, and it doesn't have to be kept around waiting for Doctor House's third act. There is nothing stopping you from a middle ground.
analog31 1y ago
In the US, this is already handled by prior authorization. /s
Ey7NFZ3P0nzAe 1y ago
Soon resident here: not really super critical to know the exact pathogen. There are classes of antibiotics and depending on many factors we can have a good estimate of what will work so the first try usually helps. What's usually done (at least in france) is: 1. Take some blood to send to the labs to grow bacterias 2. Only then IV of antibiotics 3. Adjust at day 3 when you get the results. And what if it looks super severe en urgent? Then 1. we do that too because it's often impossible to know what the pathogen was once you IVed all the antibiotics. And 2. we start by wide spectrum super strong high dose antibiotics. Example: purpura fulminans: 1g of 3rd gen cephalosporins. Ymmv in other countries, especially the USA because IIRC you have selected tons of emergent pathogens.
- darth_avocado 1y ago
  This. Literally last week, I had to go to the ER and they ran a PCR test to identify the infection. But they also started broad spectrum antibiotics immediately. But since it was a Thursday and the lab only works weekdays, I couldn’t get the results back until Tuesday. They adjusted the antibiotics to a more targeted one once the results were back.
  - Ey7NFZ3P0nzAe 1y ago
    Pretty usual stuff I'd say. And I'm willing to bet that the 2nd sets of antibiotic had a lower spectrum of action than the 1sr because we had some guess about the initial strain. Also because you're still with us so it probably worked. In any case I'm glad you're better and sorry you had to go through this.

Cthulhu_ 1y ago

Sure, but then they'd have a million(s) dollar machine (plus the people trained to operate it) waiting for these critical cases. It's a cost / benefit tradeoff, just like whether to use an MRI or CAT scan vs x-rays or an echo.

passwordoops 1y ago
Plus high-res mass specs can't just be turned on, they need to be kept on standby which isn't cheap when you cost it out over a year

mapt 1y ago

This is a false dichotomy. It doesn't have to be used for every patient, and it doesn't have to be kept around waiting for Doctor House's third act. There is nothing stopping you from a middle ground.

analog31 1y ago

In the US, this is already handled by prior authorization. /s

Ey7NFZ3P0nzAe 1y ago

Soon resident here: not really super critical to know the exact pathogen. There are classes of antibiotics and depending on many factors we can have a good estimate of what will work so the first try usually helps. What's usually done (at least in france) is: 1. Take some blood to send to the labs to grow bacterias 2. Only then IV of antibiotics 3. Adjust at day 3 when you get the results. And what if it looks super severe en urgent? Then 1. we do that too because it's often impossible to know what the pathogen was once you IVed all the antibiotics. And 2. we start by wide spectrum super strong high dose antibiotics. Example: purpura fulminans: 1g of 3rd gen cephalosporins. Ymmv in other countries, especially the USA because IIRC you have selected tons of emergent pathogens.

darth_avocado 1y ago
This. Literally last week, I had to go to the ER and they ran a PCR test to identify the infection. But they also started broad spectrum antibiotics immediately. But since it was a Thursday and the lab only works weekdays, I couldn’t get the results back until Tuesday. They adjusted the antibiotics to a more targeted one once the results were back.
- Ey7NFZ3P0nzAe 1y ago
  Pretty usual stuff I'd say. And I'm willing to bet that the 2nd sets of antibiotic had a lower spectrum of action than the 1sr because we had some guess about the initial strain. Also because you're still with us so it probably worked. In any case I'm glad you're better and sorry you had to go through this.