Antibiotic de-escalation in patients with pneumonia in the intensive care unit: A systematic review and meta-analysis

International Journal of Clinical Practice
R Ambaras Khan, Zoriah Aziz

Abstract

Antibiotic de-escalation is part of an antibiotic stewardship strategy to achieve adequate therapy for infections while avoiding the prolonged use of broad-spectrum antibiotics. However, there is a paucity of clinical evidence on the clinical impact of this strategy in pneumonia patients in the intensive care unit (ICU). This review aimed to evaluate the impact of antibiotic de-escalation therapy for adult patients diagnosed with pneumonia in the ICU. This review was conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) recommendation. Electronic databases including MEDLINE, CINAHL, PubMed, Embase, Cochrane Databases and Cochrane Central Register of Controlled Trials were searched up to March 2017 for relevant trials. The methodological quality of included trials was assessed by using a modified version of the Newcastle-Ottawa Quality Assessment Scale for Case-Control and Cohort Studies. A meta-analysis was conducted using the random-effect model to combine the rate of mortality and length of stay outcomes. Nine observational trials involving 2128 patients were considered eligible for inclusion. Although based on low quality evidence, there was a statistically significant difference in ...Continue Reading

References

Nov 1, 1994·American Journal of Epidemiology·S Shapiro
Oct 1, 1993·The Journal of Antimicrobial Chemotherapy·B L RøderN Frimodt-Møller
Dec 31, 1997·Controlled Clinical Trials·M D FlatherS Yusuf
Feb 14, 1998·BMJ : British Medical Journal·M EggerG Davey Smith
Apr 3, 2002·Emerging Infectious Diseases·Stef L A M BronzwaerUNKNOWN European Antimicrobial Resistance Surveillance System
Jul 12, 2002·Statistics in Medicine·Julian P T Higgins, Simon G Thompson
Jan 11, 2005·Critical Care Medicine·Jordi RelloEmili Diaz
May 18, 2006·Critical Care : the Official Journal of the Critical Care Forum·Francisco Alvarez-LermaUNKNOWN ADANN Study Group
Jan 6, 2007·Critical Care Medicine·Marc LeoneClaude Martin
Jun 6, 2007·Intensive Care Medicine·Elpis GiantsouKonstantinos Manolas
Mar 25, 2008·Journal of Critical Care·Ari R JoffeUNKNOWN Canadian Critical Care Trials Group
Apr 26, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
May 31, 2008·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Timothy H DellitAvery B Nathens
Jul 4, 2008·Cleveland Clinic Journal of Medicine·Esteban WalkerMichael W Kattan
Jan 13, 2009·American Journal of Respiratory and Critical Care Medicine·Kevin L Lawrence, Marin H Kollef
Dec 3, 2009·JAMA : the Journal of the American Medical Association·Jean-Louis VincentUNKNOWN EPIC II Group of Investigators
Jan 15, 2011·Critical Care : the Official Journal of the Critical Care Forum·Philippe MontraversUNKNOWN Club d'Infectiologie en Anesthésie-Réanimation Study Group
Mar 4, 2011·Critical Care : the Official Journal of the Critical Care Forum·Mi Kyong JoungKyong Ran Peck
Nov 28, 2012·Critical Care : the Official Journal of the Critical Care Forum·Marin H Kollef, Scott T Micek
Jan 22, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·James S MoltonDale A Fisher
Feb 5, 2013·The British Journal of Psychiatry : the Journal of Mental Science·Rebecca E S AnglinSarah D McDonald
Nov 15, 2013·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Anucha ApisarnthanarakLinda M Mundy
Nov 19, 2014·Critical Care : the Official Journal of the Critical Care Forum·Charles-Edouard LuytJean Chastre
Dec 26, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Alexis TabahJan J De Waele
Dec 30, 2015·Surgical Infections·Kristin C TurzaRobert G Sawyer
Jun 14, 2016·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Goh OhjiKentaro Iwata
Jul 31, 2016·The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases·Ana Carolina Souza-OliveiraDenise Von Dolinger de Brito Röder
Oct 16, 2016·American Journal of Infection Control·Víctor Daniel RosenthalUNKNOWN Remaining authors
Jun 24, 2017·International Journal of Clinical Pharmacy·Rahela Ambaras Khan, Zoriah Aziz

❮ Previous
Next ❯

Citations

Dec 21, 2018·Expert Review of Anti-infective Therapy·Calypso MathieuMarc Leone
Jul 10, 2019·Expert Review of Anti-infective Therapy·Karolin HijaziIan M Gould
Mar 18, 2020·Expert Review of Anti-infective Therapy·Inger Van HeijlCornelis H Van Werkhoven

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antimicrobial Resistance (ASM)

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Antimicrobial Resistance

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Related Papers

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
Goh OhjiKentaro Iwata
Respirology : Official Journal of the Asian Pacific Society of Respirology
Hong-Li JiangBing Mao
Drug Safety : an International Journal of Medical Toxicology and Drug Experience
Angel Y S WongIan C K Wong
© 2022 Meta ULC. All rights reserved