ArticleBMC infectious diseases2025
Carbapenem De-escalation in urinary tract infections: prevalence and outcomes among hospitalized patients.
Article in BMC infectious diseases, 2025. 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.
- Pathogen characteristics and pre-index clinical factors associated with multidrug-resistant organism infections in intensive care unit patients.Frontiers in public health · 2026Observational
- Determining the Use and Reasons for Non-De-Escalation of Empiric Carbapenem Therapy in a Private Hospital in South Africa.Antibiotics (Basel, Switzerland) · 2025Article
- Gut microbiome dysbiosis and antimicrobial resistance in the Middle East: a converging public health crisis in conflict and fragile settings.Archives of microbiology · 2025Review
- Assessment of Factors Contributing to Multidrug Resistance in Urinary Tract Infections: Focus on Carbapenem Resistance.Antibiotics (Basel, Switzerland) · 2025Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the prevalence and outcomes of carbapenem de-escalation among hospitalized urinary tract infection (UTI) patients at Jordan University Hospital from January 2022 to March 2024.
methodsThis retrospective study included adult patients who received carbapenems as empirical therapy and underwent urine culture testing. Patients who were discharged before culture results (n = 31) were excluded. The primary outcome was to assess the rate of effective de-escalation, which is the transition to a narrower-spectrum antibiotic without therapeutic failure. Secondary outcomes included the effect on successful de-escalation on patients' hospital length of stay, and the relationship between urine culture results and the success of de-escalation. When determining whether to de-escalate, factors such as clinical stability, and urine culture results and susceptibility were considered. Chi-square test assessed associations between culture results and de-escalation success.
resultsA total of 205 patients who received carbapenems as empirical therapy and underwent urine culture testing were included in the study. Out of these, 116 individuals (56.6%) had negative culture results, indicating no infection, while 89 individuals (43.4%) tested positive, confirming the presence of an infection. Among these patients, 95.6% (196 out of 205) required de-escalation of their treatment, whereas 4.4% did not. The prevalence of successful de-escalation was 40.3% (79 out of 196). The analysis revealed that successful de-escalation is much more likely in cases with urine cultures showing growth (86.8%) compared to those with no growth (17.2%) (p = 0.001). The study also indicated no significant differences in the length of hospital stay between the successfully de-escalated group and those who failed or were incorrectly de-escalated (P > 0.05).
conclusionsThe study underscores the challenges of implementing effective antibiotic stewardship in UTI management, particularly regarding carbapenem de-escalation. Enhanced protocols and clinician education are essential to optimize de-escalation practices, especially in cases with negative microbiological results. Further research is needed to refine these strategies and address the growing issue of antibiotic resistance in UTIs.
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