ArticleInfection and drug resistance2014
Safety and feasibility of antibiotic de-escalation in bacteremic pneumonia.
Article in Infection and drug resistance, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Impact of Positive Culture Reports ofInfection and drug resistance · 2023Article
- Reducing the use of empiric antibiotic therapy in COVID-19 on hospital admission.BMC infectious diseases · 2021Article
- Antibiotics De-Escalation in the Treatment of Ventilator-Associated Pneumonia in Trauma Patients: A Retrospective Study on Propensity Score Matching Method.Chinese medical journal · 2018Article
- A retrospective study of antibiotic de-escalation in patients with ventilator-associated pneumonia in Malaysia.International journal of clinical pharmacy · 2017Observational
- Modeling risk for developing drug resistant bacterial infections in an MDR-naive critically ill population.Therapeutic advances in infectious disease · 2017Article
- Advances in antibiotic therapy in the critically ill.Critical care (London, England) · 2016Review
- A Simulation Study Reveals Lack of Pharmacokinetic/Pharmacodynamic Target Attainment in De-escalated Antibiotic Therapy in Critically Ill Patients.Antimicrobial agents and chemotherapy · 2015Article
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6 authors.
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Abstract
backgroundAntibiotic de-escalation is a potential strategy advocated to conserve the effectiveness of broad-spectrum antibiotics. The aim of this study was to examine the safety and feasibility of antibiotic de-escalation in patients admitted with bacteremic pneumonia.
methodsA retrospective chart review was done for patients with bacteremic pneumonia admitted to Northwest Texas Hospital in Amarillo, TX, USA, during 2008. Antibiotic de-escalation was defined as changing the empiric antibiotic regimen to a culture-directed single agent with a narrower spectrum than the original regimen.
resultsSixty-eight patients were admitted with bacteremic pneumonia. Eight patients were not eligible for de-escalation. Among the 60 patients who were eligible for de-escalation, the treating physicians failed to de-escalate antibiotics in 27 cases (45.0%). Discharge to a long-term care facility predicted failure to de-escalate antibiotics, while an infectious diseases consultation was significantly associated with antibiotic de-escalation. The average daily cost of antibacterial therapy in the de-escalation group was $25.7 compared with $61.6 in the group where de-escalation was not implemented. The difference in mean length of hospital stay and mortality between the two groups was not statistically significant.
conclusionAntibiotic de-escalation is a safe management strategy but unfortunately is not widely adopted. Although bacterial resistance poses a significant threat and is rising, antimicrobial de-escalation has emerged as a potential intervention that can conserve the effectiveness of broad-spectrum antibiotics without compromising the patient's outcome. This practice is becoming important in the face of slow development of new anti-infective agents.
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