4/4 "Guidelines vs mindlines: A qualitative investigation of how clinicians' beliefs influence the application of rapid molecular diagnostics in intensive care", published in Antimicrobial Agents and Chemotherapy is now available.
journals.asm.org/doi/10.1128/...

3/4 Implementation strategies for technological solutions to antimicrobial resistance must be ‘behaviourally intelligent’, recognising the challenges facing clinicians when making ‘life or death’ prescribing decisions.

2/4 limiting the application of these tests in practice.
Findings underscore the challenge of changing prescribing decisions based on technical results or guidelines, highlighting factors such as clinicians’ previous experience, and ‘knowledge in practice, to be more proximal drivers of decisions.

Also sub-group analysis didn't suggest difference in outcomes between sample types but admittedly we didn't have many BALs.

No, we didn't formally assess here as had done & published before in same population. Informal analysis suggested results similar, and PCR found more organisms than culture. The method is semi-quant so you can have some clues to colonisation vs. infection - but no current method is 100% on this.

2/2 More research on clinical impact is urgently needed. A holistic approach, including behavioural intervention to optimise antibiotic prescribing, is likely needed to fully realise the potential benefits of rapid diagnostics and their role in mitigating AMR.