Evidence map›Paper›PMID 26554421›Full record

ArticleDeutsches Arzteblatt international2015

The Reduction in Antibiotic Use in Hospitals.

Karen Scholze, Mechthild Wenke, Reinhard Schierholz, Uwe Groß, Oliver Bader, Ortrud Zimmermann, Sebastian Lemmen, Jan R Ortlepp

Abstract read
In one paragraph

Article in Deutsches Arzteblatt international, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Karen ScholzeInternal Medicine and Intensive Care Medicine, Asklepios Hospital Schildautal, Seesen, Clinic for Cardiology, Pneumology, Angiology and Internal Intensive Medicine (Medical Clinic I), Uniklinik RWTH Aachen, Central Department of Hospital Hygiene and Infectiology, Uniklinik RWTH Aachen, Institute for Medical Microbiology, School of Medicine, University of Göttingen, Hospital Pharmacy, Asklepios Harz Hospitals, Goslar, Hospital Pharmacy, KRH Hanover Regional Hospital Group, Hanover.
Mechthild Wenke
Reinhard Schierholz
Uwe Groß
Oliver Bader
Ortrud Zimmermann
Sebastian Lemmen
Jan R Ortlepp

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOver 350 000 patients are treated in German hospitals for sepsis or pneumonia each year. The rate of antibiotic use in hospitals is high. The growing problem of drug resistance necessitates a reconsideration of antibiotic treatment strategies.

methodsAntibiotics were given liberally in the years 2010 and 2011 in a German 312-bed hospital. Special training, standardized algorithms to prevent unnecessary drug orders, and uniform recommendations were used in 2012 and 2013 to lessen antibiotic use. We retrospectively studied the hospital's mortality figures and microbiological findings to analyze how well these measures worked.

resultsAntibiotic consumption fell from 67.1 to 51.0 defined daily doses (DDD) per 100 patient days (p <0.001) from the period 2010-2011 to the period 2012-2013. The mortality of patients with a main diagnosis of sepsis fell from 1% (95/305) to 19% (63/327; p = 0.001), while that of patients with a main diagnosis of pneumonia fell from 12% (22/178) to 6% (15/235; p = 0.038). The overall mortality fell from 3.0% (623/ 20 954) to 2.5% (576/22 719; p = 0.005). In patients with nosocomial urinary tract infections with Gram-negative pathogens (not necessarily exhibiting three- or fourfold drug resistance), the rate of resistance to three or four of the antibiotics tested fell from 11% to 5%.

conclusionReducing in-hospital antibiotic use is an achievable goal and was associated in this study with lower mortality and less drug resistance. The findings of this single-center, retrospective study encourage a more limited and focused approach to the administration of antibiotics.

Indexed as

AgedAnti-Bacterial AgentsBacteremiaDrug PrescriptionsDrug UtilizationDrug Utilization ReviewFemaleGermanyGuideline AdherenceHospitalizationHospital MortalityHumansMalePneumonia, BacterialPractice Guidelines as TopicPrescription Drug OveruseAnti-Bacterial Agents

Identifiers

PMID26554421
PMCPMC4644935

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.