ArticleInfection2014
Antibiotic de-escalation in bacteremic urinary tract infections: potential opportunities and effect on outcome.
Article in Infection, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed.
- Targeted simplification versus antipseudomonal broad-spectrum beta-lactams in patients with bloodstream infections due toBMJ open · 2017Trial
- Proactive antimicrobial stewardship with real-time microbiological alerts improves management of bloodstream infections.JAC-antimicrobial resistance · 2025Article
- Carbapenem De-escalation in urinary tract infections: prevalence and outcomes among hospitalized patients.BMC infectious diseases · 2025Article
- Outcomes associated with initial narrow-spectrum versus broad-spectrum antibiotics in children hospitalized with urinary tract infections.Journal of hospital medicine · 2024Article
- Assessment of De-Escalation of Empirical Antimicrobial Therapy in Medical Wards with Recognized Prevalence of Multi-Drug-Resistant Pathogens: A Multicenter Prospective Cohort Study in Non-ICU Patients with Microbiologically Documented Infection.Antibiotics (Basel, Switzerland) · 2024Article
- Follow-up of patients with urinary tract infections discharged from the emergency department: a mixed methods study.The Journal of antimicrobial chemotherapy · 2024Observational
- Efficiency of the Japanese Hospitalist System for Patients with Urinary Tract Infection: A Propensity-matched Analysis.Internal medicine (Tokyo, Japan) · 2023Article
- Physician Responsiveness to Positive Blood Culture Results at the Minneapolis Veterans Affairs Hospital-Is Anyone Paying Attention?Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2021Article
- Levofloxacin: Insights Into Antibiotic Resistance and Product Quality.Frontiers in pharmacology · 2019Review
- Ceftriaxone treatment of complicated urinary tract infections as a risk factor for enterococcal re-infection and prolonged hospitalization: A 6-year retrospective study.Bosnian journal of basic medical sciences · 2018Article
- Intravenous-only or Intravenous Transitioned to Oral Antimicrobials for Enterobacteriaceae-Associated Bacteremic Urinary Tract Infection.Pharmacotherapy · 2017Article
- Benefits and unintended consequences of antimicrobial de-escalation: Implications for stewardship programs.PloS one · 2017Article
- Determinants of Deescalation Failure in Critically Ill Patients with Sepsis: A Prospective Cohort Study.Critical care research and practice · 2016Article
- High variability among Emergency Departments in 3rd-generation cephalosporins and fluoroquinolones use for community-acquired pneumonia.Infection · 2015Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to examine the safety and efficacy of antibiotic de-escalation in patients admitted with bacteremic urinary tract infection (UTI).
methodsA retrospective chart review of patients admitted to a community-hospital in West Texas with bacteremic UTI during the year 2008. Antibiotic de-escalation was defined as changing the intravenous empiric antibiotic regimen to a culture-directed single agent, given intravenously or orally, with a narrower spectrum than the original empiric regimen.
resultsNinety-seven patients were admitted with bacteremic UTI. Thirty-two patients were not eligible for de-escalation. Among the 65 patients who were eligible for de-escalation, the treating physicians failed to de-escalate antibiotics in 31 cases (47.7%). Fluoroquinolones' resistance, bacteria other than Escherichia coli and discharge to long-term care facilities predicted failure to de-escalate antibiotics. On multivariate analysis, discharge to long-term care facility was the only risk factor that predicted failure to de-escalate antibiotics. The difference between mean hospital length of stay and mortality between the above two groups was not statistically significant.
conclusionAntibiotic de-escalation is under-recognized and sporadically practiced. In patients admitted with bacteremic UTI, empiric antibiotic regimen can be changed to a culture-directed single antibiotic without an increase in hospital length of stay or patients' mortality.
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Registered trials
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