ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2012
Non-adherence to antimicrobial treatment guidelines results in more broad-spectrum but not more appropriate therapy.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 34 citations in OpenAlex.
- Adequacy of an evidence-based treatment guideline for complicated urinary tract infections in the Netherlands and the effectiveness of guideline adherence.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2013Trial
- Knowledge, attitudes, and practices of ICU physicians on antimicrobial use and resistance: a scoping review.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Review
- Incidence and outcomes of patients admitted to emergency departments with urinary tract infections in Denmark: a retrospective cohort study.Annals of medicine · 2025Article
- Effect of guideline-concordant, appropriate, and effective antimicrobial treatment on patient outcome in multidrug-resistant (MDR) infections.Microbiology spectrum · 2025Article
- Antimicrobial Stewardship Impact on Antibiotic Use in Three Tertiary Hospitals in Zambia: A Comparative Point Prevalence Survey.Antibiotics (Basel, Switzerland) · 2025Article
- Paediatric Escherichia coli urinary tract infection: susceptibility trends and clinical management-a retrospective analysis of a 10-year period.Irish journal of medical science · 2024Article
- Appropriateness of Empirical Antibiotic Therapy in Hospitalized Patients with Bacterial Infection: A Retrospective Cohort Study.Infection and drug resistance · 2023Article
- Article
- 'It makes life so much easier'-experiences of users of the MicroGuide™ smartphone app for improving antibiotic prescribing behaviour in UK hospitals: an interview study.JAC-antimicrobial resistance · 2021Article
- Article
- Hospital-Acquired Infections After Cardiac Surgery and Current Physician Practices: A Retrospective Cohort Study.Journal of clinical medicine research · 2017Article
- Perceptions and behaviours of infectious diseases physicians when managing urinary tract infections due to MDR organisms.The Journal of antimicrobial chemotherapy · 2015Article
- Evaluating antibiotic stewardship programs in patients with bacteremia using administrative data: a cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015Article
- Observational
- Antibiotic stewardship in Germany: a cross-sectional questionnaire survey of 355 intensive care units.Infection · 2014Article
- Importance of antimicrobial stewardship to the English National Health Service.Infection and drug resistance · 2014Review
- Antibiotic stewardship.Clinical medicine (London, England) · 2013Review
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Mortality in patients admitted with sepsis is high and the increasing incidence of infections with multiresistant bacteria is a worldwide problem. Many hospitals have local antimicrobial guidelines to assure effective treatment and limit the use of broad-spectrum antibiotics, thereby reducing the selection of resistant bacteria. We evaluated adherence to the antimicrobial treatment guidelines of our hospital in patients presenting to the emergency department (ED) with sepsis and assessed the in vitro susceptibility of isolated pathogens to the guideline-recommended treatment and the prescribed treatment. We included all adult patients with a known or suspected infection and two or more extended systemic inflammatory response syndrome (SIRS) criteria. Patients who did not receive antimicrobial treatment, presented with infections not included in the guidelines, or had more than one possible focus of infection were excluded. A total of 276 ED visits (262 patients) were included. Guideline-concordant treatment was prescribed in 168 visits (61%). In the case of guideline-disconcordant treatment, 87% was more broad-spectrum than guideline-recommended treatment. A microbiological diagnosis was established in 96 visits (35%). The susceptibility of the pathogens isolated from patients treated with guideline-concordant treatment (n=68) and guideline-disconcordant treatment (n=28) to guideline-recommended treatment (91% versus 89%) and to prescribed treatment (91% versus 93%) was similar (p=0.77 and p=0.79, respectively). In conclusion, non-adherence to the guidelines occurred frequently and resulted in more broad-spectrum empirical therapy. This did not result in a higher rate of susceptibility of the isolated pathogens to the prescribed empirical therapy.
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