SynthesisWorldviews on evidence-based nursing2020
The Effect of Antibiotic-Cycling Strategy on Antibiotic-Resistant Bacterial Infections or Colonization in Intensive Care Units: A Systematic Review and Meta-Analysis.
Synthesis in Worldviews on evidence-based nursing, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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
4 citing papers in PubMed, 7 citations in OpenAlex.
- Explainable Machine Learning Integrating Patient and Environmental Factors for Predicting Multidrug-Resistant Organism Colonization or Infection on ICU Admission.Infection and drug resistance · 2026Article
- Association Between Differential Heterogeneity of Antibiotics Consumption and Share of Resistant Pathogens and Its Implication for Antibiotic Stewardship in a German Hospital Intensive Care Unit.Antibiotics (Basel, Switzerland) · 2025Article
- The Actual Clinical Situation Ruthlessly Exposes the Challenge of Rational Care for Nosocomial and Community-Acquired Infections and Requires Even More Efforts for Satisfactory Antibiotic Stewardship.Antibiotics (Basel, Switzerland) · 2025Article
- Antibiotic treatment protocols revisited: the challenges of a conclusive assessment by mathematical modelling.Journal of the Royal Society, Interface · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAntibiotic-resistant bacteria, especially multidrug-resistant strains, play a key role in impeding critical patients from survival and recovery. The effectiveness of the empiric use of antibiotics in the circling manner in intensive care units (ICUs) has not been analyzed in detail and remains controversial. Therefore, this systematic review and meta-analysis were conducted to evaluate antibiotic-cycling effect on the incidence of antibiotic-resistant bacteria.
methodsWe searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science for studies focusing on whether a cycling strategy of empiric use of antibiotics could curb the prevalence of antibiotic-resistant bacteria in ICUs. The major outcomes were risk ratios (RRs) of antibiotic-resistant infections or colonization per 1,000 patient days before and after the implementation of antibiotic cycling. A random-effects model was adopted to estimate results in consideration of clinical heterogeneity among studies. The registration number of the meta-analysis is CRD42018094464.
resultsTwelve studies, involving 2,261 episodes of resistant infections or colonization and 160,129 patient days, were included in the final analysis. Based on the available evidence, the antibiotic-cycling strategy did not reduce the overall incidence of infections or colonization with resistant bacteria (RR = 0.823, 95% CI 0.655-1.035, p = .095). In subgroup analyses, the cycling strategy cut down the incidence of resistant bacteria more significantly than baseline period (p = .028) but showed no difference in comparison with mixing strategy (p = .758). LINKING EVIDENCE TO ACTION: Although the cycling strategy performed better than relatively free usage of antibiotics in the baseline period on reducing resistant bacteria, the cycling strategy did not show advantage when compared with the mixing strategy in subgroup analyses. In addition, these viewpoints still need more evidence to confirm.
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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.