Antibiotic strategies in severe nosocomial sepsis: Why do we not de-escalate more often?

Critical Care Medicine

Volumn 40, Issue 5, 2012, Pages 1404-1409

  Heenen, Sarah ^a   Jacobs, Frédérique ^a   Vincent, Jean Louis ^a  

^a ERASME HOSPITAL   (Belgium)

Author keywords

Antimicrobials; empiric antibiotics; infection; microbiology

Indexed keywords

AMIKACIN; ANTIBIOTIC AGENT; BETA LACTAM ANTIBIOTIC; CEFEPIME; CEFTAZIDIME; COTRIMOXAZOLE; FLUCONAZOLE; LINEZOLID; MEROPENEM; PIPERACILLIN PLUS TAZOBACTAM; VANCOMYCIN;

ABDOMEN; ADULT; ANTIBIOTIC SENSITIVITY; ANTIBIOTIC THERAPY; ANTIMICROBIAL THERAPY; DISEASE SEVERITY; FEMALE; HOSPITAL INFECTION; HUMAN; IN VITRO STUDY; INTENSIVE CARE; LUNG; MAJOR CLINICAL STUDY; MALE; NONHUMAN; PRIORITY JOURNAL; REVIEW; SEPSIS;

ACADEMIC MEDICAL CENTERS; ANTI-BACTERIAL AGENTS; CROSS INFECTION; DRUG THERAPY, COMBINATION; DRUG UTILIZATION REVIEW; FEMALE; HUMANS; INTENSIVE CARE UNITS; MALE; MICROBIAL SENSITIVITY TESTS; MIDDLE AGED; RETROSPECTIVE STUDIES; SEPSIS;

EID: 84860226563     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e3182416ecf     Document Type: Review

References (26)

1. Osmon S, Warren D, Seiler SM, et al: The influence of infection on hospital mortality for patients requiring-48 h of intensive care. Chest 2003; 124:1021-1029
2. Kollef MH, Sherman G, Ward S, et al: Inadequate antimicrobial treatment of infections: A risk factor for hospital mortality among critically ill patients. Chest 1999; 115:462-474
3. Iregui M, Ward S, Sherman G, et al: Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia. Chest 2002; 122:262-268
4. Garnacho-Montero J, Ortiz-Leyba C, Herrera-Melero I, et al: Mortality and morbidity attributable to inadequate empirical antimicrobial therapy in patients admitted to the ICU with sepsis: A matched cohort study. J Antimicrob Chemother 2008; 61:436-441
5. Gaieski DF, Mikkelsen ME, Band RA, et al: Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med 2010; 38:1045-1053
6. Lautenbach E, Patel JB, Bilker WB, et al: Extended-spectrum beta-lactamaseproducing Escherichia coli and Klebsiella pneumoniae: risk factors for infection and impact of resistance on outcomes. Clin Infect Dis 2001; 32:1162-1171
7. Yates RR: New intervention strategies for reducing antibiotic resistance. Chest 1999; 115:24S-27S
8. Gomes Silva BN, Andriolo RB, Atallah AN, et al: De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock. Cochrane Database Syst Rev 2010; CD007934
9. Alvarez-Lerma F, Alvarez B, Luque P, et al: Empiric broad-spectrum antibiotic therapy of nosocomial pneumonia in the intensive care unit: A prospective observational study. Crit Care 2006; 10:R78
10. Niederman MS: Impact of antibiotic resistance on clinical outcomes and the cost of care. Crit Care Med 2001; 29:N114-N120
11. Dellinger RP, Levy MM, Carlet JM, et al: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008; 36:296-327
12. Eachempati SR, Hydo LJ, Shou J, et al: Does de-escalation of antibiotic therapy for ventilator-associated pneumonia affect the likelihood of recurrent pneumonia or mortality in critically ill surgical patients? J Trauma 2009; 66:1343-1348
13. Morel J, Casoetto J, Jospe R, et al: Deescalation as part of a global strategy of empiric antibiotherapy management. A retrospective study in a medico-surgical intensive care unit. Crit Care 2010; 14:R225
14. Rello J, Gallego M, Mariscal D, et al: The value of routine microbial investigation in ventilator-associated pneumonia. Am J Respir Crit Care Med 1997; 156:196-200
15. Rello J, Vidaur L, Sandiumenge A, et al: De-escalation therapy in ventilatorassociated pneumonia. Crit Care Med 2004; 32:2183-2190
16. Leone M, Garcin F, Bouvenot J, et al: Ventilator-associated pneumonia: Breaking the vicious circle of antibiotic overuse. Crit Care Med 2007; 35:379-385
17. Giantsou E, Liratzopoulos N, Efraimidou E, et al: De-escalation therapy rates are significantly higher by bronchoalveolar lavage than by tracheal aspirate. Intensive Care Med 2007; 33:1533-1540
18. Canadian Critical Care Trials Group: A randomized trial of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med 2006; 355:2619-2630
19. Levy MM, Fink MP, Marshall JC, et al: 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003; 31:1250-1256
20. Vincent JL, Moreno R, Takala J, et al: The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 1996; 22:707-710
21. Calandra T, Cohen J, International Sepsis Forum Definition of Infection in the ICU Consensus Conference: The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med 2005; 33:1538-1548
22. Garner JS, Jarvis WR, Emori TG, et al: CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988; 16:128-140
23. Cooper GL, Hopkins CC: Rapid diagnosis of intravascular catheter-associated infection by direct Gram staining of catheter segments. N Engl J Med 1985; 312:1142-1147
24. Hoffken G, Niederman MS: Nosocomial pneumonia: the importance of a de-escalating strategy for antibiotic treatment of pneumonia in the ICU: Chest 2002; 122:2183-2196
25. Shime N, Satake S, Fujita N: De-escalation of antimicrobials in the treatment of bacteraemia due to antibiotic-sensitive pathogens in immunocompetent patients. Infection 2011; 39:319-325
26. European Center for Disease Prevention and Control: Antimicrobial resistance surveillance in Europe 2009. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Available at: http://www.ecdc.europa.eu/en/publications/Publications/1011-SUR-annual-EARS-Net- 2009.pdf. Accessed December 2, 2011