biostudies-literatureUnknown13(10)Halperin AVBloodstream infections cause great mortality and morbidity. Real-time microbiological information has been shown to have an impact on prognosis when combined with an antimicrobial stewardship (AMS) program. dRAST is a rapid commercial antimicrobial susceptibility testing (AST) system based on real-time microscopy. The primary outcome of this trial was to compare positive blood culture's time-to-result (TTR), defined as time from Gram stain to AST report, between dRAST and our standard of care in a real-life clinical setting. Secondary outcomes included microbiological concordance, time to antimicrobial stewardship recommendation (TAMS), and time to change antimicrobial prescription (TCAP) in agreement with AMS recommendation. We performed a prospective, open-label, randomized (1:1) diagnosMicrobiology spectrume0028825https://www.ebi.ac.uk/biostudies/studies/S-EPMC12502579biostudies-literatureRandomized controlled diagnostic trial to assess dRAST time to result and its utility for antimicrobial stewardship recommendation in bacteremic patients.PMC12502579Escudero RCardenas-Isasi MJGarcia-Castillo MCanton RHalperin AVCobo JGioia FSanchez-Diaz AMfalseRandomized controlled diagnostic trial to assess dRAST time to result and its utility for antimicrobial stewardship recommendation in bacteremic patients.Bloodstream infections cause great mortality and morbidity. Real-time microbiological information has been shown to have an impact on prognosis when combined with an antimicrobial stewardship (AMS) program. dRAST is a rapid commercial antimicrobial susceptibility testing (AST) system based on real-time microscopy. The primary outcome of this trial was to compare positive blood culture's time-to-result (TTR), defined as time from Gram stain to AST report, between dRAST and our standard of care in a real-life clinical setting. Secondary outcomes included microbiological concordance, time to antimicrobial stewardship recommendation (TAMS), and time to change antimicrobial prescription (TCAP) in agreement with AMS recommendation. We performed a prospective, open-label, randomized (1:1) diagnos2025-01-01T00:00:00Z2025 Oct2026-06-04T06:20:56.927Z2026-05-06T03:13:20.402ZS-EPMC125025794081516510.1128/spectrum.00288-25