Broad-spectrum antimicrobials and the treatment of serious bacterial infections: getting it right up front

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Marin H Kollef

Abstract

The treatment of serious bacterial infections is complicated by the fact that time to initiation of effective antimicrobial therapy is a strong predictor of mortality. Therefore, therapy must be initiated before the causative pathogen is identified. However, inappropriate or inadequate initial empirical therapy is associated with increased mortality, morbidity, and length of hospital stay. Initial empirical therapy with broad-spectrum antimicrobials attempts to address this dilemma by "getting it right up front." The goal is to provide treatment active against the most likely pathogens until culture/susceptibility test results are obtained. After the causative pathogen is identified, streamlining to more-precise therapy of the shortest acceptable duration is implemented. In this way, the risks of death, morbid complications, increased duration of hospital stay (as a result of ineffective initial treatment), and emergence of resistance (due to extended treatment with broad-spectrum agents) are lowered. Improved clinical and economic outcomes after such an approach have been demonstrated.

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References

Oct 1, 1991·The Journal of Antimicrobial Chemotherapy·H EdelsteinR McCabe
Jul 1, 1995·The Journal of Antimicrobial Chemotherapy·Y J Mouton, C Beuscart
Jul 1, 1997·American Journal of Respiratory and Critical Care Medicine·J RelloJ Valles
Nov 14, 1997·American Journal of Respiratory and Critical Care Medicine·M H KollefV Fraser
Dec 10, 1998·Journal of Internal Medicine·L LeiboviciS D Pitlik
Aug 5, 1999·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·B BylJ P Thys
Sep 1, 2000·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·U FluckigerA F Widmer
Feb 13, 2001·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·C Verwaest, UNKNOWN Belgian Multicenter Study Group
Mar 10, 2001·Journal of Chemotherapy·F Alvarez Lerma, UNKNOWN Serious Infection Study Group
Dec 24, 2002·The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases·Roberto BadaróUNKNOWN Latin American Antibiotic Research Group (LAARG)
Jul 11, 2003·Clinical Therapeutics·Richard G WunderinkUNKNOWN Linezolid Nosocomial Pneumonia Study Group
Jul 18, 2003·Clinical Therapeutics·LilyAnn JeuHoratio B Fung
Sep 3, 2003·The Journal of Antimicrobial Chemotherapy·Sheryl A ZelenitskyRobert E Ariano
Jun 19, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David L PatersonVictor L Yu
Aug 31, 2004·Journal of Chemotherapy·S J BermanUNKNOWN Merrem Hospital-Acquired Pneumonia Study Group
Feb 9, 2005·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society, UNKNOWN Infectious Diseases Society of America
Mar 29, 2005·Antimicrobial Agents and Chemotherapy·Scott T MicekMarin H Kollef
Apr 9, 2005·The Pediatric Infectious Disease Journal·Saro H ArmenianAntonio C Arrieta
Aug 13, 2005·Critical Care Medicine·Marin H Kollef, Scott T Micek
Sep 6, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ebbing LautenbachNeil O Fishman

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Citations

Apr 30, 2010·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·S P KusterA McGeer
Feb 11, 2011·Current Infectious Disease Reports·Anand Kumar
Aug 27, 2013·Current Infectious Disease Reports·Colleen McEvoy, Marin H Kollef
Sep 1, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Marin H KollefMarcos I Restrepo
Nov 15, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Angela M CaliendoUNKNOWN Infectious Diseases Society of America (IDSA)
Dec 25, 2012·The Journal of Antimicrobial Chemotherapy·Hang-Cheng ChenChien-Chang Lee
Dec 8, 2010·Antimicrobial Agents and Chemotherapy·Zachari TurgeonA Rod Merrill
Dec 21, 2010·Critical Care : the Official Journal of the Critical Care Forum·Jérôme MorelChristian Auboyer
Mar 17, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Marin KollefAnand Kumar
Mar 3, 2012·International Journal of Clinical Pharmacy·Lucas MagedanzRodrigo Pires dos Santos
Aug 12, 2014·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Sing-On TengWen-Sen Lee
Jan 30, 2016·Critical Care : the Official Journal of the Critical Care Forum·Matteo BassettiRichard G Wunderink
Feb 24, 2016·International Journal of Microbiology·Ayele Argaw-DenbobaAlemayehu Gashaw Mekonnen
Apr 10, 2012·Diagnostic Microbiology and Infectious Disease·Alexandre BoyerDidier Gruson
Dec 7, 2010·Enfermedades infecciosas y microbiología clínica·José María Aguado
Jun 29, 2010·Enfermedades infecciosas y microbiología clínica·Juan-Ignacio Alós, Jesús Rodríguez-Baño
Aug 12, 2009·Infectious Disease Clinics of North America·Robert C Owens
Sep 11, 2009·International Journal of Antimicrobial Agents·Ayşe ErbayNeriman Balaban
Mar 24, 2009·Diagnostic Microbiology and Infectious Disease·Ronald N JonesMatthew G Stilwell
Apr 4, 2009·International Journal of Antimicrobial Agents·Ursula Theuretzbacher
Mar 24, 2009·Diagnostic Microbiology and Infectious Disease·Thomas R FritscheRonald N Jones
Jan 1, 2012·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·David R Snydman
Nov 9, 2010·Annals of the New York Academy of Sciences·Fred C Tenover
Sep 15, 2011·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Scott T MicekMarin H Kollef
Mar 17, 2010·Journal of Veterinary Emergency and Critical Care·Dawn Merton Boothe
Jul 21, 2015·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Scott T MicekVandana Menon
Mar 11, 2015·Journal of Molecular Recognition : JMR·Miguel R Lugo, A Rod Merrill
Oct 12, 2013·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Anucha ApisarnthanarakLinda M Mundy
Jun 15, 2011·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Anthony D HarrisJon P Furuno
May 7, 2015·Critical Care : the Official Journal of the Critical Care Forum·Scott T MicekVandana Menon

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