Exact(30)
antimicrobial de-escalation.
However, the antimicrobial de-escalation could have been higher than reported.
To reduce the ecological risk associated with the increased consumption of last-line antibiotics, two main strategies are available: (1) searching for alternative treatments for ESBL-PE-related infections and (2) antimicrobial de-escalation (ADE).
Test characteristics of the spectrum score method to predict antimicrobial de-escalation were performed as above.
Antimicrobial de-escalation is a fundamental operation of antimicrobial stewardship [ 1- 5].
Comparison of antimicrobial de-escalation rates between healthcare settings is problematic.
Similar(30)
Sensitivity and specificity of the sign of spectrum score ∆ to predict antimicrobial steward de-escalation opinion (i.e., reference standard) were calculated.
Recommendations were made for further investigations, antimicrobial agents, de-escalation, and the need for formal infectious-disease consultation (a routine consultation service supervised by an attending infectious-disease staff physician).
Using an open-label randomized design, investigators from Korea randomly assigned 109 medical ICU patients with HAP to empiric therapy with imipenem (0.5 g every 6 hours) plus vancomycin (15 mg/kg every 12 hours), followed by de-escalaton (54 patients) versus conventional therapy (non-carbapenem, non-vanco-mycin empiric antimicrobials) without de-escalation (55 patients) [ 40].
We compared the early use of broad-spectrum antimicrobials plus subsequent de-escalation (DE) with conventional antimicrobial treatment (non-de-escalation, NDE) in critically ill patients with hospital-acquired pneumonia (HAP).
Also, respondents suggested that antimicrobial prescribers should incorporate de-escalation of antimicrobial chemotherapy, where indicated.
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