Evidence map›Paper›PMID 31025133›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2019

The extent of microbiological testing is associated with alteration of antibiotic therapy in adults with community-acquired pneumonia.

Esther Wittermans, Stefan M T Vestjens, Willem Jan W Bos, Jan C Grutters, Ewoudt M W van de Garde, Bart J M Vlaminckx

Open access · greenAbstract read
PubMed Publisher
In one paragraph

Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 30% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Guideline
  2. Review
  3. Review
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

6 authors at 4 institutions in 1 country.

Esther WittermansDepartment of Internal Medicine, St. Antonius Hospital, Koekoekslaan 1, P.O. Box 2500, 3430 EM, Nieuwegein, the Netherlands. e.wittermans@antoniusziekenhuis.nl.ORCID http://orcid.org/0000-0002-6035-2601
Stefan M T VestjensDepartment of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, the Netherlands.
Willem Jan W BosDepartment of Internal Medicine, St. Antonius Hospital, Koekoekslaan 1, P.O. Box 2500, 3430 EM, Nieuwegein, the Netherlands.
Jan C GruttersInterstitial Lung Diseases Centre of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, the Netherlands.
Ewoudt M W van de GardeDepartment of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, the Netherlands.
Bart J M VlaminckxDepartment of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, the Netherlands.
St. Antonius Ziekenhuis · NLLeiden University Medical Center · NLUniversity Medical Center Utrecht · NLUtrecht University · NL

Funding

St. Antonius Research Fund via an earmarked donation from Verwelius Construction Corporation N/A
6 · The paper itself

Abstract

The aim of this study was to explore the relationship between the extent of microbiological testing and the frequency of antibiotic alteration in adults hospitalised with community-acquired pneumonia (CAP). We retrospectively studied 283 immunocompetent patients hospitalised with CAP. Information on microbiological testing and prescribed antibiotics was obtained. Patients were grouped according to the number of different microbiological tests performed within the first 2 days of admission (0-5 tests). Alteration rates were compared between these groups. Antimicrobial alteration was defined as a switch at day 3 of hospital stay to (1) a narrower spectrum antibiotics, or (2) a different class of antibiotics, or (3) a switch from dual therapy to monotherapy (4) or discontinuation of antibiotic treatment because the indication for antibiotic treatment did no longer exist. For each additional test performed, a stepwise increase in percentage of patients with altered antibiotic regimen ranging from 0 to 59% (p = 0.001) was found. Multivariate logistic regression analyses showed that performing PCR assay for atypical pathogens was most strongly associated with any alteration of antibiotic treatment (OR 2.6 (95% CI 1.4-4.9)) and with changes in atypical coverage specifically (OR 3.1 (95% CI 1.6-6.0). The extent of microbiological testing was positively associated with antibiotic alteration in adults hospitalised with CAP. Antibiotic treatment was most likely to be altered in patients in whom PCR assay for atypical pathogens was performed.

Indexed as

AgedAged, 80 and overAnti-Bacterial AgentsAntimicrobial StewardshipBacteriaClinical Laboratory TechniquesCommunity-Acquired InfectionsDrug Therapy, CombinationFemaleHospitalizationHumansImmunocompetenceMaleMiddle AgedPneumoniaRetrospective StudiesAnti-Bacterial AgentsAntimicrobial stewardshipBacterial pneumoniaPolymerase chain reaction

Identifiers

PMID31025133
OpenAlexW2941620984

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.