Evidence map›Paper›PMID 40526395›Full record

ReviewJournal of clinical microbiology2025

Point-Counterpoint: Cascade reporting-useful tool to support antimicrobial stewardship, or dangerously misleading.

Joseph L Kuti, Joseph D Lutgring, Patricia J Simner, Samia N Naccache, Emily L Heil

Abstract readReview
In one paragraph

Review in Journal of clinical microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Adaptation and performance evaluation of the French society of microbiology algorithm for detection of carbapenemase-producing enterobacterales using VITEK2 antibiotic susceptibility testing system.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    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

5 authors.

Joseph L KutiCenter for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut, USA.ORCID 0000-0002-4464-3126
Joseph D LutgringDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0001-5723-8317
Patricia J SimnerDepartment of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0001-6134-151X
Samia N NaccacheLabCorp, Seattle, Washington, USA.ORCID 0009-0005-3402-3723
Emily L HeilDepartment of Practice, Sciences, and Health-Outcomes Research, University of Maryland Baltimore School of Pharmacy, Baltimore, Maryland, USA.ORCID 0000-0002-6644-6684

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Addressing antimicrobial resistance requires multi-disciplinary action, including from the clinical laboratory. Cascade reporting of the antimicrobial susceptibility test (AST) is a strategy used by some laboratories to nudge clinicians toward the use of more narrow-spectrum antimicrobials. Cascade reporting involves suppression of broader-spectrum antimicrobials if the narrower-spectrum first-line antimicrobials show in-vitro susceptibility. Studies have shown that cascade reporting can reduce use of broad-spectrum antimicrobials and reduce antimicrobial resistance rates. However, implementing cascade reporting can be complex, and some question the effectiveness on impacting long-term prescribing behaviors. Furthermore, there are concerns surrounding compliance and the possible negative impact on public health surveillance for antimicrobial resistance. In this article, experts weigh in on the benefits and risks associated with implementing AST cascade reporting. General consensus is that cascade reporting is a benefit to antimicrobial stewardship, but protocols need careful implementation to minimize risk to patients and public health.

Indexed as

Anti-Bacterial AgentsAntimicrobial StewardshipDrug Resistance, BacterialHumansMicrobial Sensitivity TestsAnti-Bacterial Agents

Identifiers

PMID40526395
PMCPMC12279290

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.