Antimicrobial De-Escalation in the ICU: From Recommendations to Level of Evidence.
Antibiotic
Antimicrobial
Documentation
Infectious disease
Multidrug resistance
Stewardship
Journal
Advances in therapy
ISSN: 1865-8652
Titre abrégé: Adv Ther
Pays: United States
ID NLM: 8611864
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
16
03
2020
pubmed:
29
5
2020
medline:
16
2
2021
entrez:
29
5
2020
Statut:
ppublish
Résumé
Antimicrobial de-escalation (ADE) is a component of antimicrobial stewardship (AMS) aimed to reduce exposure to broad-spectrum antimicrobials. In the intensive care unit, ADE is a strong recommendation that is moderately applied in clinical practice. Following a systematic review of the literature, we assessed the studies identified on the topic which included one randomized controlled trial and 20 observational studies. The literature shows a low level of evidence, although observational studies suggested that this procedure is safe. The effects of ADE on the level of resistance of ecological systems and especially on the microbiota are unclear. The reviewers recommend de-escalating antimicrobial treatment in patients requiring long-term antibiotic therapy and considering de-escalation in short-term treatments.
Identifiants
pubmed: 32462606
doi: 10.1007/s12325-020-01390-2
pii: 10.1007/s12325-020-01390-2
pmc: PMC7252418
doi:
Substances chimiques
Anti-Bacterial Agents
0
Anti-Infective Agents
0
Types de publication
Journal Article
Systematic Review
Langues
eng
Pagination
3083-3096Références
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