Evidence map›Paper›PMID 37422096›Full record

ArticleInternational journal of antimicrobial agents2023

Addition of aminoglycosides reduces recurrence of infections with multidrug-resistant Gram-negative bacilli in patients with sepsis and septic shock.

M Cristina Vazquez Guillamet, Christopher Damulira, Andrew Atkinson, Victoria J Fraser, Scott Micek, Marin H Kollef

Open access · greenAbstract read
In one paragraph

Article in International journal of antimicrobial agents, 2023. 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
0.3field-weighted citation impact, top 54% 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, 3 citations in OpenAlex.

  1. Pooled it
  2. Optimal antibiotic use in the intensive care unit.Critical care (London, England) · 2025
    Review
  3. Article
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 2 institutions in 1 country.

M Cristina Vazquez GuillametDivision of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA. Electronic address: m.c.vazquezguillamet@wustl.edu.
Christopher DamuliraWashington University, St Louis, MO, USA.
Andrew AtkinsonDivision of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
Victoria J FraserDepartment of Medicine, Washington University School of Medicine, St Louis, MO, USA.
Scott MicekSt Louis College of Pharmacy, St Louis, MO, USA.
Marin H KollefDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA. Electronic address: kollefm@wustl.edu.
Washington University in St. Louis · USUniversity of Health Sciences and Pharmacy · US

Funding

Sepsis phenotypes at risk for infections caused by multidrug resistant Gram-negative bacilli: elucidating the impact of sepsis definition and patient case mix on prediction performanceK08GM140310 · NIGMS · WASHINGTON UNIVERSITY · PI VAZQUEZ GUILLAMET, MARIA CRISTINA · 2020 to 2023
$791k
NIGMS NIH HHS K08 GM140310
6 · The paper itself

Abstract

objectivesAminoglycosides and β-lactams have been recommended for treatment of sepsis/septic shock despite a lack of mortality benefit. Previous studies have examined resistance emergence for the same bacterial isolate using old dosing regimens and during a narrow follow-up window. We hypothesised that combination regimens employing aminoglycosides will decrease the cumulative incidence of infections due to multidrug-resistant (MDR) Gram-negative bacilli (GNB) compared with β-lactams alone.

methodsAll adult patients admitted to Barnes Jewish Hospital between 2010 and 2017 with a diagnosis of sepsis/septic shock were included in this retrospective cohort study. Patients were divided into two treatment groups, with and without aminoglycosides. Patient demographics, severity of presentation, administered antibiotics, follow-up cultures with susceptibility results for a period of 4-60 days, and mortality were extracted. After propensity score matching, a Fine-Gray subdistribution proportional hazards model summarised the estimated incidence of subsequent infections with MDR-GNB in the presence of all-cause death as a competing risk.

resultsA total of 10 212 septic patients were included, with 1996 (19.5%) treated with at least two antimicrobials including one aminoglycoside. After propensity score matching, the cumulative incidence of MDR-GNB infections between 4-60 days was lower in the combination group (incidence at 60 days 0.073, 95% CI 0.062-0.085) versus patients not receiving aminoglycosides (0.116, 95% CI 0.102-0.130). Patients aged ≤65 years and with haematological malignancies had a larger treatment effect in subgroup analyses.

conclusionAddition of aminoglycosides to β-lactams may protect against subsequent infections due to MDR-GNB in patients with sepsis/septic shock.

Indexed as

Gram-Negative Bacterial InfectionsSepsisShock, SepticAdultAminoglycosidesAnti-Bacterial Agentsbeta-LactamsDrug Resistance, Multiple, BacterialGram-Negative BacteriaHumansRetrospective StudiesAminoglycosidesAnti-Bacterial Agentsbeta-LactamsAminoglycosidesAntimicrobial resistanceGram-negative bacilliSepsis

Identifiers

PMID37422096
PMCPMC11221431
OpenAlexW4383373348

What OpenQuestion holds

Textmetadata
LicenceTDM
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.