FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2334342838> ?p ?o ?g. }

• W2334342838 endingPage "A234" @default.
• W2334342838 startingPage "A234" @default.
• W2334342838 abstract "Introduction: Early administration of broad spectrum, empiric antimicrobial therapy has been shown to reduce mortality and improve outcomes in patients with severe sepsis. However broad-spectrum therapy favors the emergence of drug resistance and adds excessively to the costs of care. De-escalation refers to either discontinuation or change to a narrower spectrum antimicrobial. Methods: In this prospective, cohort study we reviewed consecutive cases admitted with severe sepsis from 1st January to 31st May 2013. Antibiotic therapy was considered appropriate based on in vitro sensitivity on culture. We categorized patients into 4 groups based on antibiotic administration upto 7 days after admission; No change in antibiotics, De-escalation (defined as stopping or changing to a narrower spectrum antibiotic),Escalation or Mixed changes. Results: 140 patients were admitted. Median age was 57 ± 21.5 years (range 19,93), 70 (50%) were female. Mean APACHE II score was 22.5 ± 7.25. 105(75%) patients had nosocomial acquisition of sepsis. Comorbid conditions included malignancy; 48(34%), purulent lung diseases (bronchiectasis, empyema);23(16%), cirrhosis, renal failure;31(22%). Most common empiric regimen was vancomycin+ carbapenems + aminoglycosides /quinolones/beta-lactams in 70(50%) patients. ICU mortality was 33(24%).Cultures were positive in 55(39%); 19 (28%) grew Pseudomonas aeruginosa of which 10(52%) were carbapenemase-producing. Empiric therapy was appropriate in 73% cases. Antimicrobial de-escalation was indicated in 76(54%) patients, of these 67 (48%) had negative cultures. Of all patients, 13(9%) patients were de-escalated, 106 (76%) were continued on the same, escalation of antimicrobials occurred in 8(6%) & in 8(6%) mixed changes were made. Physicians were most likely to de-escalate patients with hematologic malignancies, p 0.016 or those on empiric aminoglycosides, p 0.036. ICU mortality was significantly different, p 0.000 between the 4 groups; de-escalation 23% (3), escalation 25%(2),no change 24%(25), mixed changes 0%(0). Conclusions: Empiric therapy in severe sepsis/shock admitted to the ICU is reassuringly broad-spectrum and appropriate but infrequently de-escalated. Current de-escalation practices may reflect concerns for drug toxicity and physician uncertainty when cultures are negative. These results support a role for antibiotic stewardship programs." @default.
• W2334342838 created "2016-06-24" @default.
• W2334342838 creator A5001827912 @default.
• W2334342838 creator A5027590074 @default.
• W2334342838 creator A5039925650 @default.
• W2334342838 creator A5040301904 @default.
• W2334342838 creator A5065987567 @default.
• W2334342838 creator A5070716238 @default.
• W2334342838 creator A5086119461 @default.
• W2334342838 date "2013-12-01" @default.
• W2334342838 modified "2023-09-25" @default.
• W2334342838 title "932" @default.
• W2334342838 doi "https://doi.org/10.1097/01.ccm.0000440170.18362.f8" @default.
• W2334342838 hasPublicationYear "2013" @default.
• W2334342838 type Work @default.
• W2334342838 sameAs 2334342838 @default.
• W2334342838 citedByCount "3" @default.
• W2334342838 countsByYear W23343428382016 @default.
• W2334342838 countsByYear W23343428382017 @default.
• W2334342838 crossrefType "journal-article" @default.
• W2334342838 hasAuthorship W2334342838A5001827912 @default.
• W2334342838 hasAuthorship W2334342838A5027590074 @default.
• W2334342838 hasAuthorship W2334342838A5039925650 @default.
• W2334342838 hasAuthorship W2334342838A5040301904 @default.
• W2334342838 hasAuthorship W2334342838A5065987567 @default.
• W2334342838 hasAuthorship W2334342838A5070716238 @default.
• W2334342838 hasAuthorship W2334342838A5086119461 @default.
• W2334342838 hasConcept C126322002 @default.
• W2334342838 hasConcept C142724271 @default.
• W2334342838 hasConcept C177713679 @default.
• W2334342838 hasConcept C178790620 @default.
• W2334342838 hasConcept C185592680 @default.
• W2334342838 hasConcept C204787440 @default.
• W2334342838 hasConcept C2776056953 @default.
• W2334342838 hasConcept C2777628635 @default.
• W2334342838 hasConcept C2778384902 @default.
• W2334342838 hasConcept C2778715236 @default.
• W2334342838 hasConcept C2779181126 @default.
• W2334342838 hasConcept C2779375183 @default.
• W2334342838 hasConcept C2781413609 @default.
• W2334342838 hasConcept C4937899 @default.
• W2334342838 hasConcept C501593827 @default.
• W2334342838 hasConcept C71924100 @default.
• W2334342838 hasConcept C86803240 @default.
• W2334342838 hasConcept C89423630 @default.
• W2334342838 hasConcept C94665300 @default.
• W2334342838 hasConceptScore W2334342838C126322002 @default.
• W2334342838 hasConceptScore W2334342838C142724271 @default.
• W2334342838 hasConceptScore W2334342838C177713679 @default.
• W2334342838 hasConceptScore W2334342838C178790620 @default.
• W2334342838 hasConceptScore W2334342838C185592680 @default.
• W2334342838 hasConceptScore W2334342838C204787440 @default.
• W2334342838 hasConceptScore W2334342838C2776056953 @default.
• W2334342838 hasConceptScore W2334342838C2777628635 @default.
• W2334342838 hasConceptScore W2334342838C2778384902 @default.
• W2334342838 hasConceptScore W2334342838C2778715236 @default.
• W2334342838 hasConceptScore W2334342838C2779181126 @default.
• W2334342838 hasConceptScore W2334342838C2779375183 @default.
• W2334342838 hasConceptScore W2334342838C2781413609 @default.
• W2334342838 hasConceptScore W2334342838C4937899 @default.
• W2334342838 hasConceptScore W2334342838C501593827 @default.
• W2334342838 hasConceptScore W2334342838C71924100 @default.
• W2334342838 hasConceptScore W2334342838C86803240 @default.
• W2334342838 hasConceptScore W2334342838C89423630 @default.
• W2334342838 hasConceptScore W2334342838C94665300 @default.
• W2334342838 hasLocation W23343428381 @default.
• W2334342838 hasOpenAccess W2334342838 @default.
• W2334342838 hasPrimaryLocation W23343428381 @default.
• W2334342838 hasRelatedWork W1597080270 @default.
• W2334342838 hasRelatedWork W1850156223 @default.
• W2334342838 hasRelatedWork W2349759380 @default.
• W2334342838 hasRelatedWork W2411203596 @default.
• W2334342838 hasRelatedWork W2782616736 @default.
• W2334342838 hasRelatedWork W3044041316 @default.
• W2334342838 hasRelatedWork W3200197546 @default.
• W2334342838 hasRelatedWork W3208951689 @default.
• W2334342838 hasRelatedWork W4292451712 @default.
• W2334342838 hasRelatedWork W4317611848 @default.
• W2334342838 hasVolume "41" @default.
• W2334342838 isParatext "false" @default.
• W2334342838 isRetracted "false" @default.
• W2334342838 magId "2334342838" @default.
• W2334342838 workType "article" @default.