ReviewIntensive care medicine2025
Antibiotic therapy for severe bacterial infections.
Review in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 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
16 citing papers in PubMed.
- Hour-1 Sepsis Bundle: Updated Evidence.Journal of clinical medicine · 2026Review
- Rapid microbiological diagnostics for sepsis in critical care: integrating technological advances with antimicrobial stewardship.Acute and critical care · 2026Article
- Harmonizing Rigidity and Flexibility: Embedding COF Quantum Dots Into Extracellular Matrix Gel as Carbon Monoxide Depot for Acoustically Triggered Time-Programmable Anti-Infective Therapy.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Practice model of unit-based clinical pharmacists' individualized daily antimicrobial use density monitoring report on antimicrobial stewardship in intensive care unit of a tertiary hospital in Guangxi, China: an interrupted time series analysis.Antimicrobial resistance and infection control · 2026Article
- A review of bloodstream infections-pathogens, pathogenesis, diagnostic strategies, treatment methods-challenges and future aspects.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
- Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Association of a Hospital-Wide Integrated Stewardship Intervention with Hospital-Acquired Multidrug-Resistant Organism Infection Incidence Density: A Large-Scale Interrupted Time-Series Study.Antibiotics (Basel, Switzerland) · 2026Article
- The time has come for optimizing beta-lactam therapy in critically ill patients with renal dysfunction.Intensive care medicine · 2026Article
- The intestinal microbiota impacts nutritional immunity and resistance toProceedings of the National Academy of Sciences of the United States of America · 2026Article
- Research progress on self-assembled supramolecular bioactive materials from herbal natural products and their applications in anti-infection field.Materials today. Bio · 2026Review
- Washed Microbiota Transplantation as a Rescue Therapy for Refractory Unidentified Pathogen Intestinal Infections: Findings From a National Multi-Centre, Real-World Study.Microbial biotechnology · 2026Article
- Fosfomycin Use in Treating Severe Difficult-to-Treat Gram-Negative Infections-A Comprehensive Review.Antibiotics (Basel, Switzerland) · 2026Review
- Uterine microbiota dynamics and new therapeutic opportunities in gynecological diseases.American journal of translational research · 2026Review
- Severe community-acquired pneumonia: current concepts and controversies.Intensive care medicine · 2026Review
- Sepsis in end-stage liver disease and acute-on-chronic liver failure: pathophysiology, diagnostic challenges, and pharmacological management.Frontiers in pharmacology · 2026Review
- InvasiveJournal of fungi (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly antibiotic therapy for patients with severe infections is essential to improve outcomes. Conversely, use of overly broad antibiotic therapy for susceptible pathogens or unnecessary antibiotics in patients without bacterial infections is associated with adverse life-threatening events and superinfections. Antibiotics-induced changes in the human microbiota alter both immune and metabolic systems. Uncontrolled antibiotic use encourages emergence of antibiotic-resistant organisms. Around 50% of ICU patients receiving antibiotic therapy do not have confirmed infections, whilst de-escalation and shortened treatment duration are infrequently performed. Mortality from serious infections remains high, highlighting the need for treatment optimisation.
methodsNarrative review.
objectivesTo summarise the available evidence, emerging options, and unresolved controversies in optimising antibiotic therapy in severe infections.
resultsLocal epidemiology, underlying illnesses, accessibility to health care systems, and diagnostic and therapeutic resources are important factors to consider. Rapid diagnostic tests combined with individualised decision-making improve the selection of antibiotic therapy. Rapid de-escalation to narrow-spectrum monotherapy and shortening of the duration of therapy should be the rule. Uncertainty still persists regarding the personalisation of therapy for difficult-to-treat resistant bacteria. Pharmacokinetic (PK) optimisation and prolonged or continuous beta-lactam use is safe and may improve outcomes. Therapeutic drug monitoring (TDM) should be used, especially when altered volume of distribution and/or drug clearance is suspected or where toxicity is likely. The impact of TDM combined with prompt dose adjustment is encouraged. Emerging technologies including rapid broad diagnostic tests and electronic antibiotic optimisation tools will further support collaboration between pharmacists, microbiologists, infectious diseases specialists, and intensivists for optimising antibiotic therapy and stewarding these precious resources.
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40888899What OpenQuestion holds
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.