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Sökning: WFRF:(De Waele J. J.) > Antimicrobial de-es...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005194naa a2200613 4500
001oai:lup.lub.lu.se:b95f86b4-2865-45ff-898e-2e2d6af85457
003SwePub
008200615s2020 | |||||||||||000 ||eng|
0247 a https://lup.lub.lu.se/record/b95f86b4-2865-45ff-898e-2e2d6af854572 URI
0247 a https://doi.org/10.1007/s00134-020-06111-52 DOI
040 a (SwePub)lu
041 a engb eng
042 9 SwePub
072 7a art2 swepub-publicationtype
072 7a ref2 swepub-contenttype
1001 a De Bus, Liesbetu Ghent University Hospital4 aut
2451 0a Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure : the DIANA study
264 c 2020-06-09
264 1b Springer Science and Business Media LLC,c 2020
300 a 14 s.
520 a PURPOSE: The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation.METHODS: Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure.RESULTS: Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60-1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14-1.64).CONCLUSION: ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Anestesi och intensivvård0 (SwePub)302012 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Anesthesiology and Intensive Care0 (SwePub)302012 hsv//eng
7001 a Depuydt, Pieteru Ghent University4 aut
7001 a Steen, Johanu Ghent University Hospital4 aut
7001 a Dhaese, Sofie4 aut
7001 a De Smet, Ken4 aut
7001 a Tabah, Alexisu University of Queensland4 aut
7001 a Akova, Muratu Ankara University4 aut
7001 a Cotta, Menino Osbertu University of Queensland4 aut
7001 a De Pascale, Gennarou Catholic University of the Sacred Heart, Rome4 aut
7001 a Dimopoulos, Georgeu National and Kapodistrian University of Athens4 aut
7001 a Fujitani, Shigekiu St. Marianna University Hospital Kawasaki4 aut
7001 a Garnacho-Montero, Jose4 aut
7001 a Leone, Marc4 aut
7001 a Lipman, Jeffrey4 aut
7001 a Ostermann, Marlies4 aut
7001 a Paiva, José-Artur4 aut
7001 a Schouten, Jeroen4 aut
7001 a Sjövall, Fredriku Lund University,Lunds universitet,Klinisk neurofysiologi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Mitokondriell Medicin,Forskargrupper vid Lunds universitet,Clinical Neurophysiology,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Mitochondrial Medicine,Lund University Research Groups,Skåne University Hospital4 aut0 (Swepub:lu)expb-fsa
7001 a Timsit, Jean-François4 aut
7001 a Roberts, Jason A4 aut
7001 a Zahar, Jean-Ralph4 aut
7001 a Zand, Farid4 aut
7001 a Zirpe, Kapil4 aut
7001 a De Waele, Jan Ju Ghent University Hospital4 aut
7001 a Spångfors, Martinu Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Central Hospital Kristianstad4 cre0 (Swepub:lu)med-ms40
7102 a Ghent University Hospitalb Ghent University4 org
7102 a DIANA study group
7730 t Intensive Care Medicined : Springer Science and Business Media LLCg 46:7, s. 1404-1417q 46:7<1404-1417x 0342-4642x 1432-1238
8564 u http://dx.doi.org/10.1007/s00134-020-06111-5x freey FULLTEXT
8564 u https://link.springer.com/content/pdf/10.1007/s00134-020-06111-5.pdf
8564 8u https://lup.lub.lu.se/record/b95f86b4-2865-45ff-898e-2e2d6af85457
8564 8u https://doi.org/10.1007/s00134-020-06111-5

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