Evidence map›Paper›PMID 42128247›Full record

ArticleThe Journal of antimicrobial chemotherapy2026

Emulating a target trial of early compared with late initiation of appropriate antibiotic therapy for hospital-acquired monobacterial Gram-negative bloodstream infections.

Abdullah T Aslan, Yukiko Ezure, Elif Seren Tanriverdi, Osman Dağ, Cansu Cimen, Ayşe Kaya Kalem, Bircan Kayaaslan, Sevil Alkan, Bahadır Köylü, Emine Büşra Ata and 44 more

Abstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

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.

2 · The registry

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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

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0 citing papers in PubMed.

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4 · The record

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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

54 authors.

Abdullah T AslanFaculty of Health, Medicine and Behavioural Sciences, UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia.ORCID 0000-0002-7844-8097
Yukiko EzureFaculty of Health, Medicine and Behavioural Sciences, UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia.
Elif Seren TanriverdiFaculty of Medicine, Department of Medical Microbiology, Inönü University, Malatya, Türkiye.
Osman DağFaculty of Medicine, Department of Biostatistics, Hacettepe University, Ankara, Türkiye.
Cansu CimenDepartment of General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Antwerp, Belgium.
Ayşe Kaya KalemAnkara Yildirim Beyazit University, Faculty of Medicine, Ankara Bilkent City Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Türkiye.
Bircan KayaaslanAnkara Yildirim Beyazit University, Faculty of Medicine, Ankara Bilkent City Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Türkiye.
Sevil AlkanFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye.
Bahadır KöylüSchool of Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Türkiye.
Emine Büşra AtaSchool of Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Türkiye.
Bilge ÇağlarCerrahpaşa Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Istanbul, Türkiye.
Neşe SaltoğluCerrahpaşa Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Istanbul, Türkiye.
Uğur ÖnalFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Uludağ University, Bursa, Türkiye.
Seçil DenizSchool of Medicine, Department of Infectious Diseases and Clinical Microbiology, Pamukkale University, Denizli, Türkiye.
Onur UralFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Selçuk University, Konya, Türkiye.
Murtaza ÖzFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Türkiye.
Mehmet BakirFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Türkiye.
Mesut YilmazFaculty of Medicine, Department of Infectious Diseases and Microbiology, Istanbul Medipol University, Istanbul, Türkiye.
Rümeysa ÇakmakFaculty of Medicine, Department of Infectious Diseases and Microbiology, Istanbul Medipol University, Istanbul, Türkiye.
Ayşe BatirelSchool of Medicine, Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Türkiye.ORCID 0000-0002-6005-636X
Özlem AkdoğanDepartment of Infectious Diseases and Clinical Microbiology, Erol Olçok Education and Research Hospital, Hitit University, Çorum, Türkiye.
Nurcan BaykamDepartment of Infectious Diseases and Clinical Microbiology, Erol Olçok Education and Research Hospital, Hitit University, Çorum, Türkiye.
Çiğdem ErolFaculty of Medicine, Department of Infectious Diseases and Microbiology, Başkent University, Ankara, Türkiye.
Tuğba Yanik-YalçinFaculty of Medicine, Department of Infectious Diseases and Microbiology, Başkent University, Ankara, Türkiye.
Oya Özlem Eren-KutsoyluFaculty of Medicine, Department of Infectious Diseases and Microbiology, Dokuz Eylül University, İzmir, Türkiye.
Zeynep Türe-YüceFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Erciyes University, Kayseri, Türkiye.
Gamze Kalin-ÜnüvarFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Erciyes University, Kayseri, Türkiye.
Zuhal Özer-ŞimşekDepartment of Internal Medicine, Division of Intensive Care, Kayseri City Hospital, Kayseri, Türkiye.
Seda GüzeldağDepartment of Internal Medicine, Division of Intensive Care Medicine, Adana Seyhan State Hospital, Adana, Türkiye.
Adem KöseFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Inönü University, Malatya, Türkiye.ORCID 0000-0002-1853-1243
Mustafa CihangiroğluFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Türkiye.
Dilek Yağci-CaglayikFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Marmara University, Istanbul, Türkiye.
Muhammed Burak SevinçFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Çapa, Istanbul, Türkiye.
Zerrin AktaşIstanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul University, Çapa, Istanbul, Türkiye.
Oral ÖncülFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Çapa, Istanbul, Türkiye.
Gülden ErsözFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mersin University, Mersin, Türkiye.
Ayşe Sesin KocagözFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Türkiye.
Gülşen HazirolanFaculty of Medicine, Department of Medical Microbiology, Hacettepe University, Ankara, Türkiye.
Tuğçe Ünalan-AltintopFaculty of Medicine, Department of Medical Microbiology, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Türkiye.
Bedia DinçDepartment of Medical Microbiology, Ankara City Hospital, Ankara, Türkiye.
Nazmiye Ülkü TüzemenFaculty of Medicine, Department of Medical Microbiology, Uludağ University, Bursa, Türkiye.
Alper AkçaliFaculty of Medicine, Department of Medical Microbiology, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye.
Salih MaçinFaculty of Medicine, Department of Medical Microbiology, Selcuk University, Konya, Türkiye.
Ahmet ÇalişkanSchool of Medicine, Department of Medical Microbiology, Pamukkale University, Denizli, Türkiye.
Mürşit HasbekFaculty of Medicine, Department of Medical Microbiology, Sivas Cumhuriyet University, Sivas, Türkiye.
Cem ErgonFaculty of Medicine, Department of Medical Microbiology, Dokuz Eylül University, İzmir, Türkiye.
Yasemin Ay-AltintopDepartment of Medical Microbiology, Kayseri City Hospital, Kayseri, Türkiye.
Müge ŞimşekDepartment of Medical Microbiology, Adana Seyhan State Hospital, Adana, Türkiye.
Barış OtluFaculty of Medicine, Department of Medical Microbiology, Inönü University, Malatya, Türkiye.
Kay A RamsayFaculty of Health, Medicine and Behavioural Sciences, UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia.
Patrick N A HarrisFaculty of Health, Medicine and Behavioural Sciences, UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia.ORCID 0000-0002-2895-0345
Murat AkovaSchool of Medicine, Department of Infectious Diseases and Microbiology, Hacettepe University, Ankara, Türkiye.ORCID 0000-0002-6904-9473
David L PatersonADVANCE-ID, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Study Group for Carbapenem Resistance (SCARE)

Funding

Pfizer 65207785University of Queensland
6 · The paper itself

Abstract

backgroundDelays in appropriate antimicrobial therapy can increase the risk of all-cause mortality (ACM) in hospital-acquired bloodstream infections (HA-BSIs) caused by Gram-negative bacteria (GNB). We aimed to evaluate the effectiveness of early appropriate antimicrobial therapy (EAAT) compared with late appropriate antimicrobial therapy (LAAT) in this population.

methodsThis study used data from a multi-centre, prospective cohort including adult patients with HA-BSI caused by GNB across 22 Turkish hospitals. A hypothetical target trial allocating participants with HA-BSI caused by monobacterial GNB to either EAAT or LAAT was emulated using the weighting approach. The primary outcome was 14 day ACM; 28 day ACM was a secondary outcome. Cox proportional hazards models with inverse probability weighting were applied to account for confounding, with antibiotic treatment incorporated as a time-dependent variable.

resultsAmong 680 patients, 14 day ACM occurred in 14.7% (40/272) of the EAAT group and 42.9% (175/408) of the LAAT group. EAAT was associated with a lower risk of 14 day ACM [adjusted hazard ratio (aHR) = 0.41; 95% CI: 0.28-0.61). Similarly, 26.1% (71/272) of the patients treated with EAAT and 49.5% (202/408) of those receiving LAAT died during 28 day follow-up (aHR = 0.66; 95% CI: 0.50-0.86). In the carbapenem-resistant GNB subset, EAAT reduced the hazard of 14 day ACM (aHR = 0.36; 95% CI: 0.21-0.60) and 28 day ACM (aHR = 0.60; 95% CI: 0.44-0.84). All prespecified and post hoc analyses consistently supported these findings.

conclusionsEAAT was associated with a survival benefit in individuals with HA-BSI due to GNB. Although these findings support early initiation of appropriate therapy, residual confounding cannot be excluded.

Indexed as

Anti-Bacterial AgentsBacteremiaCross InfectionGram-Negative Bacterial InfectionsAdultAgedAged, 80 and overFemaleGram-Negative BacteriaHumansMaleMiddle AgedProspective StudiesSurvival AnalysisTreatment DelayTreatment OutcomeAnti-Bacterial Agents

Identifiers

PMID42128247
PMCPMC13171036

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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.