De-escalation and Streamlining of Antimicrobial Therapy

Outcomes Associated With Antimicrobial De-escalation of Treatment for Pneumonia Within the Veterans Healthcare Administration

De-escalation, an antimicrobial stewardship concept, involves narrowing broad-spectrum empiric antimicrobial therapy based on clinical data. Current health outcomes evidence is lacking to support de-escalation. Studying Veterans Healthcare Administration pneumonia patients, de-escalation was associated with improved length of stay without affecting 30-day readmission or 30-day Clostridium diffi...

Antibiotic strategies in severe nosocomial sepsis: why do we not de-escalate more often?

OBJECTIVES To assess the use of antibiotic de-escalation in patients with hospital-acquired severe sepsis in an academic setting. DESIGN We reviewed all episodes of severe sepsis treated over a 1-yr period in the department of intensive care. Antimicrobial therapy was considered as appropriate when the antimicrobial had in vitro activity against the causative microorganisms. According to the ...

Bloodstream Infection: The Influence of Risk Factors, Etiology and Antimicrobial Therapy on Mortality Rates

Introduction: Inappropriate initial antimicrobial therapy leads to higher mortality in patients with bloodstream infection. This study aimed to evaluate the relationship between risk factors, etiology and antimicrobial therapy on mortality rates of patients with bloodstream infection. Methods: Between January 2016 to December 2016, 167 patients with bloodstream infection were prospectively eval...

Early Antimicrobial De-escalation Is Associated with Decreased Acute Kidney Injury in Patients Receiving Empiric Combination Therapy

De-escalation, adequacy of antibiotic therapy and culture positivity in septic patients: an observational study

OBJECTIVE To evaluate the prevalence of antibiotic de-escalation in patients diagnosed with severe sepsis or septic shock at a public academic tertiary hospital and to evaluate antibiotic adequacy and culture positivity. METHODS The prevalence of antibiotic de-escalation, the adequacy of antibiotic treatment and the rates of culture positivity were analyzed in patients with severe sepsis and ...