دورية أكاديمية
Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study
| العنوان: | Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study |
|---|---|
| المؤلفون: | Bus, Liesbet De, Depuydt, Pieter, Steen, Johan, Dhaese, Sofie, Smet, Ken De, Tabah, Alexis, Akova, Murat, Cotta, Menino Osbert, Pascale, Gennaro De, Dimopoulos, George, Fujitani, Shigeki, Garnacho-Montero, Jose, Leone, Marc, Lipman, Jeffrey, Ostermann, Marlies, Paiva, José-Artur, Schouten, Jeroen, Sjövall, Fredrik, Timsit, Jean-François, Roberts, Jason A., Zahar, Jean-Ralph, Zand, Farid, Zirpe, Kapil, Waele, Jan J. De, Rios, Fernando, Vazquez, Alejandro Risso, Vidal, Maria Gabriela, Zakalik, Graciela, Attokaran, Antony George, Banakh, Iouri, Dey-Chatterjee, Smita, Ewan, Julie, Ferrier, Janet, Forbes, Loretta, Fourie, Cheryl, Leditschke, Anne, Murray, Lauren, Eller, Philipp, Biston, Patrick, Bracke, Stephanie, Crop, Luc De, Schryver, Nicolas De, Frans, Eric, Spapen, Herbert, Malderen, Claire Van, Vansteelandt, Stijn, Vermeiren, Daisy, Arévalo, Elias Pablo, Crespo, Mónica, Flores, Roberto Zelaya, Píza, Petr, Tutillo, Diego Morocho, Elme, Andreas, Kallaste, Anne, Starkopf, Joel, Bourenne, Jeremy, Calypso, Mathieu, Cohen, Yves, Dahyot-Fizelier, Claire, Depret, François, Guillot, Max, Imzi, Nadia, Jochmans, Sebastien, Kouatchet, Achille, Lepape, Alain, Martin, Olivier, Heim, Markus, Schaller, Stefan J, Arvaniti, Kostoula, Bekridelis, Anestis, Ioannidis, Panagiotis, Mitrakos, Cornelia, Papanikolaou, Metaxia N., Pouriki, Sofia, Vemvetsou, Anna, Abraham, Babu, Bhattacharya, Pradip Kumar, Budugu, Anusha, Dixit, Subhal, Gurav, Sushma, Kandanuri, Padmaja, Prabhu, Dattatray Arun, Rathod, Darshana, Savaru, Kavitha, Udupa, Ashwin Neelavar, Varghese, Sunitha Binu, Bakhodaei, Hossein Haddad, Dabiri, Gholamreza, Fallahi, Mohammad Javad, Feiz, Farnia, Firoozifar, Mohammad, Khaloo, Vahid, Maghsudi, Behzad, Masjedi, Mansoor, Nikandish, Reza, Sabetian, Golnar, Marsh, Brian, Martin-Loeches, Ignacio, Steiner, Jan, Barbagallo, Maria, Caricato, Anselmo, Cortegiani, Andrea, D’Andrea, Rocco, Deana, Cristian, Donati, Abele, Girardis, Massimo, Mandalà, Giuliana, Panarello, Giovanna, Pasero, Daniela, Pelagalli, Lorella, Soave, Paolo Maurizio, Spadaro, Savino, Fujita, Yoshihito, Fujiwara, Shinsuke, Hara, Yuya, Hashi, Hideki, Hashimoto, Satoru, Hashimoto, Hideki, Hayakawa, Katsura, Inoue, Masash, Isokawa, Shutaro, Kameda, Shinya, Kamohara, Hidenobu, Kanamoto, Masafumi, Katayama, Shinshu, Kawagishi, Toshiomi, Kawano, Yasumasa, Kida, Yoshiko, Kita, Mami, Kobayashi, Atsuko, Kuriyama, Akira, Naito, Takaki, Nashiki, Hiroshi, Nishiyama, Kei, Shindo, Shunsuke, Suzuki, Taketo, Takaba, Akihiro, Tanaka, Chie, Tetsuya, Komuro, Tomioka, Yoshihiro, Yanagawa, Youichi, Yoshida, Hideki, Adnan, Syamhanin, Hasan, Mohd Shahnaz, Sulaiman, Helmi, Lopez, Gilberto A. Gasca, Hernández-Cárdenas, Carmen M., Ñamendys-Silva, Silvio A., Bethlehem, Carina, Lange, Dylan de, Hunfeld, Nicole, Numan, Sandra, Leeuwen, Henk van, Owens, Daniel, Almeida, Mónica, Fragoso, Elsa, Leonor, Tiago, Pereira, José-Manuel, Filipescu, Daniela, Grigoras, Ioana, Popescu, Mihai, Tomescu, Dana, Alshahrani, Mohammed S., Alvarez-Gonzalez, Manuel, Barrero-García, Irene, Blasco-Navalpotro, Miguel Angel, Claverias, Laura, Estella, Ángel, Espina, Lorena Forcelledo, Garmendia, Jose Luis Garcia, Prieto, Emilio García, Gómez-Prieto, Gracia, Conde, Carlos Jiménez, Sagasti, Fernando Martinez, Cantero, Alicia Muñoz, Orejas-Gallego, Alberto, Papiol, Elisabeth, Pérez-Civantos, Demetrio, Laderas, Juan Carlos Pozo, Álvarez, Josep Trenado, Vera-Artázcoz, Paula, Cortés, Pablo Vidal, Oldner, Anders, Spångfors, Martin, Alp, Emine, Köksal, Iftihar, Korten, Volkan, Özveren, Arife, Hall, Anna, Hatton, Kevin W., Laudanski, Krzysztof, other, and |
| المصدر: | Intensive Care Medicine |
| بيانات النشر: | Springer |
| سنة النشر: | 2020 |
| المجموعة: | Queensland University of Technology: QUT ePrints |
| الوصف: | Purpose: The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods: Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results: Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion: ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | https://eprints.qut.edu.au/228875/1/106998737.pdfTest; Bus, Liesbet De, Depuydt, Pieter, Steen, Johan, Dhaese, Sofie, Smet, Ken De, Tabah, Alexis, Akova, Murat, Cotta, Menino Osbert, Pascale, Gennaro De, Dimopoulos, George, Fujitani, Shigeki, Garnacho-Montero, Jose, Leone, Marc, Lipman, Jeffrey, Ostermann, Marlies, Paiva, José-Artur, Schouten, Jeroen, Sjövall, Fredrik, Timsit, Jean-François, Roberts, Jason A., Zahar, Jean-Ralph, Zand, Farid, Zirpe, Kapil, Waele, Jan J. De, Rios, Fernando, Vazquez, Alejandro Risso, Vidal, Maria Gabriela, Zakalik, Graciela, Attokaran, Antony George, Banakh, Iouri, Dey-Chatterjee, Smita, Ewan, Julie, Ferrier, Janet, Forbes, Loretta, Fourie, Cheryl, Leditschke, Anne, Murray, Lauren, Eller, Philipp, Biston, Patrick, Bracke, Stephanie, Crop, Luc De, Schryver, Nicolas De, Frans, Eric, Spapen, Herbert, Malderen, Claire Van, Vansteelandt, Stijn, Vermeiren, Daisy, Arévalo, Elias Pablo, Crespo, Mónica, Flores, Roberto Zelaya, Píza, Petr, Tutillo, Diego Morocho, Elme, Andreas, Kallaste, Anne, Starkopf, Joel, Bourenne, Jeremy, Calypso, Mathieu, Cohen, Yves, Dahyot-Fizelier, Claire, Depret, François, Guillot, Max, Imzi, Nadia, Jochmans, Sebastien, Kouatchet, Achille, Lepape, Alain, Martin, Olivier, Heim, Markus, Schaller, Stefan J, Arvaniti, Kostoula, Bekridelis, Anestis, Ioannidis, Panagiotis, Mitrakos, Cornelia, Papanikolaou, Metaxia N., Pouriki, Sofia, Vemvetsou, Anna, Abraham, Babu, Bhattacharya, Pradip Kumar, Budugu, Anusha, Dixit, Subhal, Gurav, Sushma, Kandanuri, Padmaja, Prabhu, Dattatray Arun, Rathod, Darshana, Savaru, Kavitha, Udupa, Ashwin Neelavar, Varghese, Sunitha Binu, Bakhodaei, Hossein Haddad, Dabiri, Gholamreza, Fallahi, Mohammad Javad, Feiz, Farnia, Firoozifar, Mohammad, Khaloo, Vahid, Maghsudi, Behzad, Masjedi, Mansoor, Nikandish, Reza, Sabetian, Golnar, Marsh, Brian, Martin-Loeches, Ignacio, Steiner, Jan, Barbagallo, Maria, Caricato, Anselmo, Cortegiani, Andrea, D’Andrea, Rocco, Deana, Cristian, Donati, Abele, Girardis, Massimo, Mandalà, Giuliana, Panarello, Giovanna, Pasero, Daniela, Pelagalli, Lorella, Soave, Paolo Maurizio, Spadaro, Savino, Fujita, Yoshihito, Fujiwara, Shinsuke, Hara, Yuya, Hashi, Hideki, Hashimoto, Satoru, Hashimoto, Hideki, Hayakawa, Katsura, Inoue, Masash, Isokawa, Shutaro, Kameda, Shinya, Kamohara, Hidenobu, Kanamoto, Masafumi, Katayama, Shinshu, Kawagishi, Toshiomi, Kawano, Yasumasa, Kida, Yoshiko, Kita, Mami, Kobayashi, Atsuko, Kuriyama, Akira, Naito, Takaki, Nashiki, Hiroshi, Nishiyama, Kei, Shindo, Shunsuke, Suzuki, Taketo, Takaba, Akihiro, Tanaka, Chie, Tetsuya, Komuro, Tomioka, Yoshihiro, Yanagawa, Youichi, Yoshida, Hideki, Adnan, Syamhanin, Hasan, Mohd Shahnaz, Sulaiman, Helmi, Lopez, Gilberto A. Gasca, Hernández-Cárdenas, Carmen M., Ñamendys-Silva, Silvio A., Bethlehem, Carina, Lange, Dylan de, Hunfeld, Nicole, Numan, Sandra, Leeuwen, Henk van, Owens, Daniel, Almeida, Mónica, Fragoso, Elsa, Leonor, Tiago, Pereira, José-Manuel, Filipescu, Daniela, Grigoras, Ioana, Popescu, Mihai, Tomescu, Dana, Alshahrani, Mohammed S., Alvarez-Gonzalez, Manuel, Barrero-García, Irene, Blasco-Navalpotro, Miguel Angel, Claverias, Laura, Estella, Ángel, Espina, Lorena Forcelledo, Garmendia, Jose Luis Garcia, Prieto, Emilio García, Gómez-Prieto, Gracia, Conde, Carlos Jiménez, Sagasti, Fernando Martinez, Cantero, Alicia Muñoz, Orejas-Gallego, Alberto, Papiol, Elisabeth, Pérez-Civantos, Demetrio, Laderas, Juan Carlos Pozo, Álvarez, Josep Trenado, Vera-Artázcoz, Paula, Cortés, Pablo Vidal, Oldner, Anders, Spångfors, Martin, Alp, Emine, Köksal, Iftihar, Korten, Volkan, Özveren, Arife, Hall, Anna, Hatton, Kevin W., Laudanski, Krzysztof, & other, and (2020) Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study. Intensive Care Medicine, 46(7), pp. 1404-1417.; https://eprints.qut.edu.au/228875Test/ |
| الإتاحة: | https://doi.org/10.1007/s00134-020-06111-5Test https://eprints.qut.edu.au/228875Test/ |
| حقوق: | free_to_read ; http://creativecommons.org/licenses/by-nc/4.0Test/ ; 2020 The Author(s) ; This work is covered by copyright. Unless the document is being made available under a Creative Commons Licence, you must assume that re-use is limited to personal use and that permission from the copyright owner must be obtained for all other uses. If the document is available under a Creative Commons License (or other specified license) then refer to the Licence for details of permitted re-use. It is a condition of access that users recognise and abide by the legal requirements associated with these rights. If you believe that this work infringes copyright please provide details by email to qut.copyright@qut.edu.au |
| رقم الانضمام: | edsbas.D6162BB5 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |