SynthesisBMC infectious diseases2018
A systematic review of the association between delayed appropriate therapy and mortality among patients hospitalized with infections due to Klebsiella pneumoniae or Escherichia coli: how long is too long?
Synthesis in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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.
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.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Real-world use of ceftolozane/tazobactam: a systematic literature review.Antimicrobial resistance and infection control · 2021Pooled it
- Beyond the Cumulative Antibiogram: A Weighted-Incidence Syndromic Combination Antibiogram to Guide Empirical Therapy of Bloodstream Infections in the Emergency Department.Infectious diseases and therapy · 2026Article
- Assessing the impact of bacteremia and antibiotic resistance on mortality in patients with monomicrobial and polymicrobial Escherichia coli necrotizing fasciitis.BMC infectious diseases · 2026Article
- The Impact of Early Empirical Antibiotic Therapy on the Mortality of Bacteremia Patients with Klebsiella Infection: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Co-evolution of resistance and virulence inFrontiers in cellular and infection microbiology · 2026Review
- A Retrospective Study of Cefiderocol Utilization and Associated Outcomes at an Academic Medical Center.Infectious disease reports · 2025Article
- 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
- Evaluation of Adjunctive Aminoglycoside Therapy Compared to β-Lactam Monotherapy in Critically Ill Patients with Gram-Negative Bloodstream Infections.Antibiotics (Basel, Switzerland) · 2025Article
- Low NAPR as a Novel Indicator for PredictingClinical interventions in aging · 2025Article
- Clinical Outcomes of Early Phenotype-Desirable Antimicrobial Therapy for Enterobacterales Bacteremia.JAMA network open · 2024Article
- Comparative analysis of a rapid diagnostic test and scoring tools for ESBL detection inMicrobiology spectrum · 2024Article
- Predicting Extended-Spectrum Beta-Lactamase and Carbapenem Resistance in Enterobacteriaceae Bacteremia: A Diagnostic Model Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2023Review
- Comparison of Risk Stratification Approaches to Identify Patients with Clostridioides difficile Infection at Risk for Multidrug-Resistant Organism Gut Microbiota Colonization.Infectious diseases and therapy · 2023Article
- Identification of outcomes reported for hospital antimicrobial stewardship interventions using a systematic review of reviews.JAC-antimicrobial resistance · 2023Review
- Leveraging diagnostic stewardship within antimicrobial stewardship programmes.Drugs in context · 2023Review
- Machine learning to identify risk factors associated with the development of ventilated hospital-acquired pneumonia and mortality: implications for antibiotic therapy selection.Frontiers in medicine · 2023Article
- Epidemiology and Economic Outcomes Associated with Timely versus Delayed Receipt of Appropriate Antibiotic Therapy among US Patients Hospitalized for Native Septic Arthritis: A Retrospective Cohort Study.Antibiotics (Basel, Switzerland) · 2022Article
- Impact of Inappropriate Empirical Antibiotic on Outcomes in Community-acquired Third Generation Cephalosporin ResistantInfection & chemotherapy · 2022Article
- Quantifying Gram-Negative Resistance to Empiric Treatment After Repeat ExpoSure To AntimicRobial Therapy (RESTART).Open forum infectious diseases · 2022Article
- Appropriateness of empirical antibiotic prescription for bloodstream infections in an emergency department from 2006 to 2018: impact of the spread of ESBL-producing Enterobacterales.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
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 at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTemporal relationships between the time to appropriate antibiotic therapy and outcomes are not well described.
methodsA systematic literature review and meta-analysis was performed to examine this relationship in patients hospitalized with Klebsiella pneumoniae or Escherichia coli infections.
resultsTwenty identified studies contained data for patients who received delayed appropriate therapy (DAT) versus appropriate antibiotic therapy for these pathogens. Of the 20 included studies, the majority (19/20) focused on patients with bloodstream infections, and only 1 study evaluated patients with pneumonia. When all DAT results were combined (any delay > 24 h from culture collection or any delay after culture and susceptibility reporting [C& SR]), there was an increased risk of mortality (odds ratio [OR], 1.60 [95% CI, 1.25-2.50]). The risk of mortality was greater when DAT > 48 h from culture collection or DAT > C&SR results were combined (OR, 1.76 [95% CI, 1.27-2.44]).
conclusionsOur findings suggest there is a need to shift current treatment practices away from antibiotic escalation strategies that contribute to delayed appropriate therapy and toward early, relatively aggressive and comprehensive, antibiotic therapy, especially among patients with bloodstream infections due to K. pneumoniae or E. coli.
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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.