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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004782naa a2200589 4500
001oai:DiVA.org:uu-475451
003SwePub
008220602s2022 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4754512 URI
0247 a https://doi.org/10.1016/j.cmi.2021.11.0252 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Paul, Mical4 aut
2451 0a European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European society of intensive care medicine)
264 1b Elsevier,c 2022
338 a print2 rdacarrier
520 a ScopeThese ESCMID guidelines address the targeted antibiotic treatment of third-generation cephalosporin-resistant Enterobacterales (3GCephRE) and carbapenem-resistant Gram-negative bacteria, focusing on the effectiveness of individual antibiotics and on combination versus monotherapy.MethodsAn expert panel was convened by ESCMID. A systematic review was performed including randomized controlled trials and observational studies, examining different antibiotic treatment regimens for the targeted treatment of infections caused by the 3GCephRE, carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii. Treatments were classified as head-to-head comparisons between individual antibiotics and between monotherapy and combination therapy regimens, including defined monotherapy and combination regimens only. The primary outcome was all-cause mortality, preferably at 30 days and secondary outcomes included clinical failure, microbiological failure, development of resistance, relapse/recurrence, adverse events and length of hospital stay. The last search of all databases was conducted in December 2019, followed by a focused search for relevant studies up until ECCMID 2021. Data were summarized narratively. The certainty of the evidence for each comparison between antibiotics and between monotherapy and combination therapy regimens was classified by the GRADE recommendations. The strength of the recommendations for or against treatments was classified as strong or conditional (weak).RecommendationsThe guideline panel reviewed the evidence per pathogen, preferably per site of infection, critically appraising the existing studies. Many of the comparisons were addressed in small observational studies at high risk of bias only. Notably, there was very little evidence on the effects of the new, recently approved, β-lactam/β-lactamase inhibitors on infections caused by carbapenem-resistant Gram-negative bacteria. Most recommendations are based on very-low- and low-certainty evidence. A high value was placed on antibiotic stewardship considerations in all recommendations, searching for carbapenem-sparing options for 3GCephRE and limiting the recommendations of the new antibiotics for severe infections, as defined by the sepsis-3 criteria. Research needs are addressed.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Infektionsmedicin0 (SwePub)302092 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Infectious Medicine0 (SwePub)302092 hsv//eng
653 a Acinetobacter baumannii
653 a Carbapenem-resistant bacteria
653 a ESCMID
653 a GRADE
653 a Multidrug resistant bacteria
7001 a Carrara, Elena4 aut
7001 a Retamar, Pilar4 aut
7001 a Tängdén, Thomasu Uppsala universitet,Infektionsmedicin4 aut0 (Swepub:uu)thota437
7001 a Bitterman, Roni4 aut
7001 a Bonomo, Robert A.4 aut
7001 a de Waele, Jan4 aut
7001 a Daikos, George L.4 aut
7001 a Akova, Murat4 aut
7001 a Harbarth, Stephan4 aut
7001 a Pulcini, Celine4 aut
7001 a Garnacho-Montero, José4 aut
7001 a Seme, Katja4 aut
7001 a Tumbarello, Mario4 aut
7001 a Lindemann, Paul Christoffer4 aut
7001 a Gandra, Sumanth4 aut
7001 a Yu, Yunsong4 aut
7001 a Bassetti, Matteo4 aut
7001 a Mouton, Johan W.4 aut
7001 a Tacconelli, Evelina4 aut
7001 a Rodríguez-Baño, Jesús4 aut
7102 a Uppsala universitetb Infektionsmedicin4 org
7730 t Clinical Microbiology and Infectiond : Elsevierg 28:4, s. 521-547q 28:4<521-547x 1198-743Xx 1469-0691
8564 u http://www.clinicalmicrobiologyandinfection.com/article/S1198743X21006790/pdf
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-475451
8564 8u https://doi.org/10.1016/j.cmi.2021.11.025

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