Evidence map›Paper›PMID 33625621›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2021

Trimethoprim-sulfamethoxazole as de-escalation in ventilator-associated pneumonia: a cohort study subanalysis.

Alessio Strazzulla, Maria Concetta Postorino, Tracie Youbong, Maxence Rouyer, Clara Flateau, Catherine Chakvetadze, Astrid de Pontfarcy, Aurelia Pitsch, Sebastien Jochmans, Nabil Belfeki and 2 more

Open access · bronzeAbstract read
In one paragraph

Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2021. 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
0.6field-weighted citation impact, top 33% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Characteristics ofAntimicrobial stewardship & healthcare epidemiology : ASHE · 2024
    Article
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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

12 authors at 1 institution in 1 country.

Alessio StrazzullaInternal Medicine Unit, Groupe Hospitalier Sud Ile de France, Melun, France. alessio.strazzulla@ghsif.fr.ORCID http://orcid.org/0000-0003-0199-3449
Maria Concetta PostorinoInfectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Tracie YoubongInfectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Maxence RouyerInfectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Clara FlateauInfectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Catherine ChakvetadzeInfectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Astrid de PontfarcyInfectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Aurelia PitschMedical Biology Laboratory, Groupe Hospitalier Sud Ile de France, Melun, France.
Sebastien JochmansIntensive Care Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Nabil BelfekiInternal Medicine Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Mehran MonchiIntensive Care Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Sylvain DiamantisInternal Medicine Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
Melun Hospital · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis is a subanalysis of a previous study which compared the effectiveness of trimetoprim-sulfametoxazole (TMP-SMX) with all other regimens for treatment of ventilator-associated pneumonia (VAP). Aim of the current study was to focus on the effectiveness of a strategy based on TMP-SMX as de-escalation from β-lactam including regimens.

methodsRetrospective cohort study including patients who were hospitalized for VAP from 2011 to 2019. Patients were distributed in two groups: NO SWITCH TO TMP-SMX group, including patients who received β-lactams for all treatment duration, and SWITCH TO TMP-SMX group, which included patients who switched to TMP-SMX from a β-lactam including regimen after microbiology diagnosis. Three clinical outcomes were analyzed: mortality at 30 days from the start of the antibiotic treatment (T30), mortality at the end of treatment (EoT), and acquisition of multidrug-resistant bacteria during hospitalization in intensive care unit.

resultsOverall, 70 patients were included in the current study, 32/70 (45.7%) in NO SWITCH TO TMP-SMX group and 38/70 (54.3%) in SWITCH TO TMP-SMX group, 37/70 (52.8%) had been already included in the previous study. No significant differences in clinical outcomes and patient's characteristics were found when the two groups were compared.

conclusionsDe-escalation to TMP-SMX for VAP treatment was not associated with higher mortality at EoT and T30 than standard treatment with β-lactam. Monotherapy with TMP-SMX as de-escalation from broad-spectrum empirical regimens is a β-lactam sparing strategy worthy to be further investigated in either multicenter cohort studies or randomized clinical trials.

Indexed as

AdultAgedAnti-Bacterial AgentsCohort StudiesFemaleHumansMaleMiddle AgedPneumonia, Ventilator-AssociatedRetrospective StudiesTrimethoprim, Sulfamethoxazole Drug CombinationAnti-Bacterial AgentsTrimethoprim, Sulfamethoxazole Drug Combinationde-escalationtrimethoprim-sulfamethoxazoleventilator-associated pneumoniaβ-lactam sparing strategy

Identifiers

PMID33625621
PMCPMC7902240
OpenAlexW3131097128

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.