ArticleCritical care explorations2023
Impact of Antibiotic Time-Outs in Multidisciplinary ICU Rounds for Antimicrobial Stewardship Program on Patient Survival: A Controlled Before-and-After Study.
Article in Critical care explorations, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 5 citations in OpenAlex.
- 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
- The PRECISE framework: a structured approach to antibiogram interpretation for antimicrobial optimization at the bedside.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Antimicrobial stewardship from a One Health perspective.Nature reviews. Microbiology · 2026Review
- Duration Matters: Tailoring Antibiotic Therapy for Ventilator-Associated Pneumonia.Antibiotics (Basel, Switzerland) · 2026Review
- Where antibiotic time-outs work: department- and ward-stratified effects of a pharmacist-led anti-MRSA time-out.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Antimicrobial Resistance in Intensive Care Units in Somalia: A Commentary on Measurement Gaps and Facility-Level Priorities for Infection Prevention and Stewardship.Infection and drug resistance · 2026Article
- Lab efficiency and improvements in the management of bloodstream infections: a before and after study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Observational
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8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The antimicrobial stewardship program (ASP) is an important quality improvement initiative that is recommended in the ICU. However, the shortage of infectious disease physicians in Japan has led to the need for simpler methods for implementing ASPs. We investigated whether antibiotic time-outs (ATOs) during multidisciplinary rounds as part of an ASP can improve patient survival and reduce the number of days of therapy (DOT) with antibiotics.
designSingle-center controlled before-and-after study.
settingMedical/surgical ICU in a tertiary university medical center in Tokyo, Japan. PATIENTS: All patients 16 years old or older admitted consecutively in the ICU between October 2016 and March 2020.
interventionsAn intensivist-driven ICU multidisciplinary round was introduced in October 2016, and ATOs with ICU rounds were implemented in June 2018. ATOs were conducted 3, 7, and 14 days after initiation of antibiotics. MEASUREMENTS AND MAIN
resultsThe primary outcome was the subdistribution hazard ratio (SHR) of survival to hospital discharge compared between multidisciplinary rounds (phase 1) and ATO during multidisciplinary rounds (phase 2) using the multivariable Fine-Gray model. The secondary outcomes were the SHR of survival to ICU discharge and the trends in the DOT with IV antibiotics per 1,000 patient-days between October 2016 and March 2020 by using interrupted time-series analysis. The number of patients in phases 1 and 2 was 777 and 796, respectively. The group that underwent ATO during multidisciplinary rounds showed a significant increase in the survival to hospital discharge in comparison with the multidisciplinary round-only group (SHR, 1.13; 95% CI, 1.02-1.25); however, the SHR of survival to ICU discharge showed no significant intergroup difference. The DOT with total IV antibiotics decreased after ATO implementation (change in intercept, -178.26; 95% CI, -317.74 to -38.78; change in slope, -7.00; 95% CI, -15.77 to 1.78).
conclusionsATOs during multidisciplinary rounds are associated with improved patient survival and reduced DOT.
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