A Systematic Review of the Definitions, Determinants, and Clinical Outcomes of Antimicrobial De-escalation in the Intensive Care Unit

Clinical Infectious Diseases

Volumn 62, Issue 8, 2016, Pages 1009-1017

  Tabah, Alexis ^a,b   Cotta, Menino Osbert ^a,b,c   Garnacho Montero, Jose ^f   Schouten, Jeroen ^g   Roberts, Jason A ^a,b,c   Lipman, Jeffrey ^a,b,d   Tacey, Mark ^e   Timsit, Jean François ^h,i   Leone, Marc ^j   Zahar, Jean Ralph ^k   De Waele, Jan J ^l  

^a ROYAL BRISBANE AND WOMEN'S HOSPITAL   (Australia)

^b and Critical Care Research Centre   (Australia)

^c UNIVERSITY OF QUEENSLAND   (Australia)

^d QUEENSLAND UNIVERSITY OF TECHNOLOGY   (Australia)

^e UNIVERSITY OF MELBOURNE   (Australia)

^f HOSPITAL UNIVERSITARIO VIRGEN MACARENA   (Spain)

^g CANISIUS WILHELMINA HOSPITAL   (Netherlands)

^h INSERM   (France)

ⁱ UNIVERSITÉ PARIS DIDEROT   (France)

^j AIX MARSEILLE UNIVERSITY   (France)

^k UNIVERSITÉ D'ANGERS   (France)

^l GHENT UNIVERSITY HOSPITAL   (Belgium)

more..

Author keywords

de escalation; resistance; stewardship; streamlining

Indexed keywords

AMINOGLYCOSIDE; ANTIBIOTIC AGENT; BETA LACTAM; CARBAPENEM; IMIPENEM; LEVOFLOXACIN; MEROPENEM; PIPERACILLIN PLUS TAZOBACTAM; VANCOMYCIN; ANTIINFECTIVE AGENT;

ABDOMINAL INFECTION; ANTIBIOTIC RESISTANCE; ANTIBIOTIC THERAPY; ANTIMICROBIAL DE ESCALATION; ARTICLE; BLOOD CULTURE; DRUG COST; DRUG TREATMENT FAILURE; HEALTH CARE ASSOCIATED PNEUMONIA; HOSPITAL ACQUIRED PNEUMONIA; HOSPITAL INFECTION; HUMAN; INTENSIVE CARE UNIT; OUTCOME ASSESSMENT; PHARMACEUTICAL CARE; PNEUMONIA; PRIORITY JOURNAL; SEPSIS; SEPTIC SHOCK; SYSTEMATIC REVIEW; TREATMENT OUTCOME; VENTILATOR ASSOCIATED PNEUMONIA; BACTERIAL INFECTIONS; CLINICAL TRIAL (TOPIC); COHORT ANALYSIS; CROSS INFECTION; MICROBIOLOGY; SEVERITY OF ILLNESS INDEX; STATISTICS AND NUMERICAL DATA;

ANTI-BACTERIAL AGENTS; BACTERIAL INFECTIONS; CLINICAL TRIALS AS TOPIC; COHORT STUDIES; CROSS INFECTION; DRUG RESISTANCE, MICROBIAL; HUMANS; INTENSIVE CARE UNITS; SEVERITY OF ILLNESS INDEX; TREATMENT OUTCOME;

EID: 84964724307     PISSN: 10584838     EISSN: 15376591     Source Type: Journal    
DOI: 10.1093/cid/civ1199     Document Type: Article

References (29)

1. Guidelines for the management of adults with hospital-acquired, ventilatorassociated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005; 171:388-416.
2. Dellinger RP, Levy MM, Rhodes A, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013; 39:165-228.
3. Dellit TH, Owens RC, McGowan JE Jr, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007; 44:159-77.
4. Silva BN, Andriolo RB, Atallah AN, Salomao R. De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock. Cochrane Database Syst Rev 2013; 3:CD007934.
5. Effective Practice and Organisation of Care (EPOC). EPOC resources for review authors. Oslo, Norway: Norwegian Knowledge Centre for the Health Services; 2014. Available at: http://epoc.cochrane.org/epoc-specific-resources-reviewauthors. Accessed 19 January 2016.
6. Higgins JPT, Green S, eds. Cochrane handbook for systematic reviews of interventions. Version 5.1.0. The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org/. Accessed 19 January 2016.
7. Wells GA, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at: http://www.ohri.ca/programs/clinical-epidemiology/oxford.asp. Accessed 19 January 2016.
8. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33:159-74.
9. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327:557-60.
10. Der Simonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7:177-88.
11. 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.
12. 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; 33:1533-40.
13. Eachempati SR, Hydo LJ, Shou J, Barie PS. 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; 66:1343-8.
14. De Waele JJ, Ravyts M, Depuydt P, Blot SI, Decruyenaere J, Vogelaers D. Deescalation after empirical meropenem treatment in the intensive care unit: fiction or reality? J Crit Care 2010; 25:641-6.
15. Morel J, Casoetto J, Jospe R, et al. De-escalation as part of a global strategy of empiric antibiotherapy management: a retrospective study in a medico-surgical intensive care unit. Crit Care 2010; 14.
16. Joung MK, Lee JA, Moon SY, et al. Impact of de-escalation therapy on clinical outcomes for intensive care unit-acquired pneumonia. Crit Care 2011; 15:R79.
17. Heenen S, Jacobs F, Vincent JL. Antibiotic strategies in severe nosocomial sepsis: Why do we not de-escalate more often? Crit Care Med 2012; 40:1404-9.
18. Kim JW, Chung J, Choi SH, et al. Early use of imipenem/cilastatin and vancomycin followed by de-escalation versus conventional antimicrobials without deescalation for patients with hospital-acquired pneumonia in a medical ICU: a randomized clinical trial. Crit Care 2012; 16:R28.
19. Gonzalez L, Cravoisy A, Barraud D, et al. Factors influencing the implementation of antibiotic de-escalation and impact of this strategy in critically ill patients. Crit Care 2013; 17:R140.
20. Knaak E, Cavalieri SJ, Elsasser GN, Preheim LC, Gonitzke A, Destache CJ. Does antibiotic de-escalation for nosocomial pneumonia impact intensive care unit length of stay? Infect Dis Clin Pract 2013; 21:172-6.
21. Mokart D, Slehofer G, Lambert J, et al. De-escalation of antimicrobial treatment in neutropenic patients with severe sepsis: results from an observational study. Intensive Care Med 2014; 40:41-9.
22. Garnacho-Montero J, Gutierrez-Pizarraya A, Escoresca-Ortega A, et al. Deescalation of empirical therapy is associated with lower mortality in patients with severe sepsis and septic shock. Intensive Care Med 2014; 40:32-40.
23. Leone M, Bechis C, Baumstarck K, et al. De-escalation versus continuation of empirical antimicrobial treatment in severe sepsis: a multicenter non-blinded randomized noninferiority trial [published erratum appears in Intensive Care Med 2014; 40:1794]. Intensive Care Med 2014; 40:1399-408.
24. Paskovaty A, Pastores SM, Gedrimaite Z, Kostelecky N, Riedel ER, Seo SK. Antimicrobial de-escalation in septic cancer patients: is it safe to back down? Intensive Care Med 2015; 41:2022-3.
25. Weiss E, Zahar JR, Lesprit P, et al. Elaboration of a consensual definition of de-escalation allowing a ranking of beta-lactams. Clin Microbiol Infect 2015; 21:649.e1-10.
26. Madaras-Kelly K, Jones M, Remington R, Hill N, Huttner B, Samore M. Development of an antibiotic spectrum score based on Veterans Affairs culture and susceptibility data for the purpose of measuring antibiotic de-escalation: a modified Delphi approach. Infect Control Hosp Epidemiol 2014; 35:1103-13.
27. Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit: a proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med 2000; 162(2; pt 1):505-11.
28. Armand-Lefevre L, Angebault C, Barbier F, et al. Emergence of imipenemresistant gram-negative bacilli in intestinal flora of intensive care patients. Antimicrob Agents Chemother 2013; 57:1488-95.
29. Carlier M, Roberts JA, Stove V, Verstraete AG, Lipman J, De Waele JJ. A simulation study reveals lack of pharmacokinetic/pharmacodynamic target attainment in de-escalated antibiotic therapy in critically ill patients. Antimicrob Agents Chemother 2015; 59:4689-94.