SynthesisThe Korean journal of internal medicine2023
The impact of antimicrobial de-escalation therapy in culture-negative pneumonia: a systematic review and meta-analysis.
Synthesis in The Korean journal of internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Diagnostic value of cytokine detection in children with Mycoplasma pneumoniae pneumonia complicated by bacterial or viral co-infections.BMC pediatrics · 2026Article
- Evaluation of the clinical impact of de-escalated versus non-de-escalated antibiotics for the treatment of methicillin-susceptible staphylococcus aureus pneumonia in critically ill patients admitted to intensive care units: a multicenter cohort study.BMC infectious diseases · 2026Article
- The Analysis of Missed Antibiotic De-Escalation Opportunities in Gram-Negative Bloodstream Infections.Antibiotics (Basel, Switzerland) · 2025Article
- An investigation of broad-spectrum antibiotic-induced liver injury based on the FDA Adverse Event Reporting System and retrospective observational study.Scientific reports · 2024Observational
- Implementing antimicrobial stewardship: lessons and perspectives from a university-affiliated tertiary hospital in Korea.The Korean journal of internal medicine · 2024Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
BACKGROUND/
aimsAntimicrobial de-escalation (ADE) remains a challenging strategy in the treatment of pneumonia. We investigated the outcomes of ADE as measured by mortality and duration of the use of antibiotics in patients with culture- negative pneumonia.
methodsWe performed a systematic review and meta-analysis in accordance with PRISMA guidelines. The primary outcome was inpatient mortality.
resultsWe examined six studies comprising 11,933 subjects, of whom 1,152 received ADE. Overall, the ADE strategy was associated with a statistically lower risk of in-hospital mortality compared with non-ADE (risk ratio [RR] = 0.60, 95% confidence interval [CI] = 0.38 to 0.93). Although substantial heterogeneity was found among the included studies (I2 = 66%), a meta-regression analysis could not reveal plausible sources of heterogeneity. And ADE was associated with a shorter duration of total and initial antibiotic therapies and total length of hospital stay compared with non-ADE.
conclusionOur findings suggest that ADE seems to be significantly associated with better clinical outcomes compared with non-ADE. Caution is demanded when interpreting data of this study because of substantial between-study heterogeneity.
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