ReviewAntibiotics (Basel, Switzerland)2024
Antimicrobial De-Escalation in Critically Ill Patients.
Review in Antibiotics (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- 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
- Association of early serial serum NLRP3 measurements with 28-day mortality in sepsis: a single-center retrospective landmark cohort study.BMC infectious diseases · 2026Article
- Implementation of the BIOFIRE Meningitis/Encephalitis Panel: A Mixed-Methods Implementation Study in a Nonmetropolitan Tertiary Hospital.Open forum infectious diseases · 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
- Day-4 antipseudomonal and anti-MRSA de-escalation was not associated with higher mortality in critically ill patients with sepsis.Frontiers in medicine · 2026Article
- Gram-negative bloodstream infections: where can we do better? A retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Observational
- Optimal antibiotic use in the intensive care unit.Critical care (London, England) · 2025Review
- Evaluating a Targeted Antimicrobial Stewardship Program and Its Temporal Association with Resistance Trends in a Veterinary Referral Hospital.Veterinary sciences · 2025Article
- Application of Real-Time PCR Syndromic Panel on Lower Respiratory Tract Samples: Potential Use for Antimicrobial De-Escalation.Microorganisms · 2025Article
- Ceftazidime/Avibactam for the Treatment of Infections in Children: A Case Series of Real-World Use.Paediatric drugs · 2025Review
- Evaluation of the Efficacy of a Nomogram to Predict Multidrug-Resistant Pulmonary Infections Based on Data from Neurosurgery Ward Patients.Infection and drug resistance · 2025Article
- Incidence and Antibiotic Susceptibility of Gram-Negative Bacteria Associated With Chest Infections in Intensive Care Unit Patients From a Selected Hospital in the Kingdom of Saudi Arabia.BioMed research international · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Antimicrobial de-escalation (ADE) is defined as the discontinuation of one or more antimicrobials in empirical therapy, or the replacement of a broad-spectrum antimicrobial with a narrower-spectrum antimicrobial. The aim of this review is to provide an overview of the available literature on the effectiveness and safety of ADE in critically ill patients, with a focus on special conditions such as anti-fungal therapy and high-risk categories. Although it is widely considered a safe strategy for antimicrobial stewardship (AMS), to date, there has been no assessment of the effect of de-escalation on the development of resistance. Conversely, some authors suggest that prolonged antibiotic treatment may be a side effect of de-escalation, especially in high-risk categories such as neutropenic critically ill patients and intra-abdominal infections (IAIs). Moreover, microbiological documentation is crucial for increasing ADE rates in critically ill patients with infections, and efforts should be focused on exploring new diagnostic tools to accelerate pathogen identification. For these reasons, ADE can be safely used in patients with infections, as confirmed by high-quality and reliable microbiological samplings, although further studies are warranted to clarify its applicability in selected populations.
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Registered trials
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.