ArticleIntensive care medicine2020
Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP).
Article in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 2 of them syntheses that pooled it.
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Who cites it
98 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Recommendations for antibacterial therapy in adults with COVID-19 - an evidence based guideline.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2021Guideline
- Antimicrobial De-Escalation in the ICU: From Recommendations to Level of Evidence.Advances in therapy · 2020Pooled it
- De-Escalation of Broad-Spectrum and Last-Resort Antibiotics in Critically Ill Adults with Gram-Negative Infections: A Scoping Review and Evidence-Informed Framework for Tertiary-Care ICUs.Antibiotics (Basel, Switzerland) · 2026Review
- A multi-site observational study of rationality assessment for carbapenem use in China: carbapenem stewardship opportunities.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Article
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- A diagnostic stewardship bundle approach to facilitate same-day optimal antimicrobial therapy in gram-negative sepsis: a quasi-experimental study.Scientific reports · 2026Article
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- Article
- Article
- Postoperative Antibiotic Escalation After Major Free-Flap Reconstruction Requiring ICU Admission: Associations with Day-1 Procalcitonin, Shock, and Microbiological Positivity.Life (Basel, Switzerland) · 2026Article
- Day-4 antipseudomonal and anti-MRSA de-escalation was not associated with higher mortality in critically ill patients with sepsis.Frontiers in medicine · 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
- Assessing the feasibility of a platform trial for Gram negative bloodstream infections: results from the vanguard phase of BALANCE.BMJ open · 2025Article
- Diagnostic efficacy of targeted next-generation sequencing in suspected lower respiratory tract infections of patients with cancer: a retrospective study.Scientific reports · 2025Article
- Blood transcriptomic for the diagnosis of nosocomial infections in critically ill patients: an observational proof-of-concept study.Infection · 2025Observational
- Gram-negative bloodstream infections: where can we do better? A retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Observational
- Optimal antibiotic use in the intensive care unit.Critical care (London, England) · 2025Review
- New Insights inAntibiotics (Basel, Switzerland) · 2025Article
- The Analysis of Missed Antibiotic De-Escalation Opportunities in Gram-Negative Bloodstream Infections.Antibiotics (Basel, Switzerland) · 2025Article
38 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial de-escalation (ADE) is a strategy of antimicrobial stewardship, aiming at preventing the emergence of antimicrobial resistance (AMR) by decreasing the exposure to broad-spectrum antimicrobials. There is no high-quality research on ADE and its effects on AMR. Its definition varies and there is little evidence-based guidance for clinicians to use ADE in the intensive care unit (ICU).
methodsA task force of 16 international experts was formed in November 2016 to provide with guidelines for clinical practice to develop questions targeted at defining ADE, its effects on the ICU population and to provide clinical guidance. Groups of 2 experts were assigned 1-2 questions each within their field of expertise to provide draft statements and rationale. A Delphi method, with 3 rounds and an agreement threshold of 70% was required to reach consensus.
resultsWe present a comprehensive document with 13 statements, reviewing the evidence on the definition of ADE, its effects in the ICU population and providing guidance for clinicians in subsets of clinical scenarios where ADE may be considered.
conclusionADE remains a topic of controversy due to the complexity of clinical scenarios where it may be applied and the absence of evidence to the effects it may have on antimicrobial resistance.
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