SynthesisCritical care (London, England)2015
Incidence and outcome of inappropriate in-hospital empiric antibiotics for severe infection: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 107 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Clinical Outcome Study of High-dose Meropenem in Sepsis and Septic Shock Patients
Evaluating Hospital Educator-led Academic Detailing on Improving Antibiotic Prescribing in Primary Healthcare: a Feasibility Study
The Impact of Fast Antimicrobial Sensitivity Testing Tools on Stewardship Antibiotic and Clinical Outcome: a Randomized Clinical Trial Within an Adaptive Platform Trial for Patients With Bloodstream Infections
Who cites it
107 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Inappropriate antibiotic prescribing in Ethiopian hospitals: a systematic review.International journal of clinical pharmacy · 2026Pooled it
- Surveillance of antimicrobial utilization in Africa: a systematic review and meta-analysis of prescription rates, indications, and quality of use from point prevalence surveys.Antimicrobial resistance and infection control · 2024Pooled it
- Effects of Inappropriate Administration of Empirical Antibiotics on Mortality in Adults With Bacteraemia: Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Randomized controlled diagnostic trial to assess dRAST time to result and its utility for antimicrobial stewardship recommendation in bacteremic patients.Microbiology spectrum · 2025Trial
- Rapid MALDI-TOF MS antimicrobial susceptibility testing with the MBT FAST assay.Journal of clinical microbiology · 2026Article
- Direct rapid antimicrobial susceptibility testing (RAST) from positive blood cultures: Recent advances, challenges, and future directions.Practical laboratory medicine · 2026Review
- When might we consider using the newer β-lactam agents as empirical therapy against presumed carbapenem-resistant gram-negative infections?JAC-antimicrobial resistance · 2026Review
- Rapid and modular workflows for same-day sequencing-based detection of bloodstream infections and antimicrobial resistance determinants using culture-enriched samples.Microbiology spectrum · 2026Article
- Assessing appropriateness of antibiotic therapy: a scoping review of definitions and their clinical implication.Infection · 2026Article
- Structured integration of rapid antimicrobial susceptibility testing and antimicrobial resistance detection into an antimicrobial stewardship programme for bacteraemia.JAC-antimicrobial resistance · 2026Article
- ASP-COMPLEX: redefining antimicrobial stewardship to improve outcomes in high-risk patients with severe infections.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Blood culture practices and microbiological capacity for sepsis diagnostics in Europe (2021-2022): a cross-sectional analysis of the European Sepsis Care Survey.The Lancet regional health. Europe · 2026Article
- Cost-Effectiveness of Automated Blood Culture Systems: Comparison of BACT/ALERT VIRTUO and BD BACTEC FX from a Provider Perspective.ClinicoEconomics and outcomes research : CEOR · 2026Article
- Deep learning-driven morphological fingerprinting: rapid, accurate and low-cost pathogen identification via the analysis of dried patterns of droplets.Journal of nanobiotechnology · 2025Article
- Monitoring for early prediction of gram-negative bacteremia using machine learning and hematological data in the emergency department.Communications medicine · 2025Article
- Implementation and Early Outcomes of an Antimicrobial Stewardship Program in South Korea.Antibiotics (Basel, Switzerland) · 2025Article
- Direct Disk Diffusion Testing and Antimicrobial Stewardship for Gram-Negative Bacteremia in the Context of High Multidrug Resistance.Antibiotics (Basel, Switzerland) · 2025Article
- Evaluation of QuickMIC system for rapid antimicrobial susceptibility testing of Gram-negative pathogens from positive blood cultures, including strains producing extended-spectrum β-lactamases and carbapenemases.Microbiology spectrum · 2025Article
- Article
- Association Between Delayed Broad-Spectrum Gram-negative Antibiotics and Clinical Outcomes: How Much Does Getting It Right With Empiric Antibiotics Matter?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
47 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aims of this study were to explore the incidence of in-hospital inappropriate empiric antibiotic use in patients with severe infection and to identify its relationship with patient outcomes.
methodsMedline (from 2004 to 2014) was systematically searched by using predefined inclusion criteria. Reference lists of retrieved articles were screened for additional relevant studies. The systematic review included original articles reporting a quantitative measure of the association between the use of (in)appropriate empiric antibiotics in patients with severe in-hospital infections and their outcomes. A meta-analysis, using a random-effects model, was conducted to quantify the effect on mortality by using risk ratios.
resultsIn total, 27 individual articles fulfilled the inclusion criteria. The percentage of inappropriate empiric antibiotic use ranged from 14.1% to 78.9% (Q1-Q3: 28.1% to 57.8%); 13 of 27 studies (48.1%) described an incidence of 50% or more. A meta-analysis for 30-day mortality and in-hospital mortality showed risk ratios of 0.71 (95% confidence interval 0.62 to 0.82) and 0.67 (95% confidence interval 0.56 to 0.80), respectively. Studies with outcome parameter 28-day and 60-day mortality reported significantly (P ≤0.02) higher mortality rates in patients receiving inappropriate antibiotics. Two studies assessed the total costs, which were significantly higher in both studies (P ≤0.01).
conclusionsThis systematic review with meta-analysis provides evidence that inappropriate use of empiric antibiotics increases 30-day and in-hospital mortality in patients with a severe infection.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.