FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4200417847> ?p ?o ?g. }

• W4200417847 endingPage "S748" @default.
• W4200417847 startingPage "S748" @default.
• W4200417847 abstract "Abstract Background Hospital-acquired and ventilator-associated pneumonia (HAP/VAP) cause significant morbidity and mortality. Guidelines recommend broad-spectrum empiric antibiotic therapy, including treatment for Pseudomonas aeruginosa (PSAR) and methicillin-resistant Staphylococcus aureus (MRSA), followed by de-escalation (DE). This study sought to assess the impact of DE on treatment failure. Methods This single-center retrospective cohort study screened all adult patients with a discharge diagnosis code for pneumonia from 2016–2019. Patients were enrolled if they met pre-defined criteria for HAP/VAP ≥48 hours after admission. Date of pneumonia diagnosis was defined as day 0. Spectrum scores were calculated, and DE was defined as a score reduction on day 3 versus day 1. Patients with DE were compared to patients with no de-escalation (NDE). Data were compared using chi-square, Mann-Whitney U, or T-tests. The primary outcome was composite treatment failure, defined as all-cause mortality or re-admission for pneumonia within 30 days of diagnosis, analyzed using a Cox proportional hazards analysis to control for confounding variables. Figure 1. Study Schematic Table 1. Spectrum Score Assignment Results Of 11860 admissions screened, 1812 unique patient-admissions were included (1102 HAP, 710 VAP). Fewer patients received DE (876 DE vs. 1026 NDE). Groups were well-matched at baseline, although more patients receiving DE had respiratory cultures ordered (56.6% vs. 50.6%, P=0.011). Patients receiving DE experienced a 65% and 44% reduction in anti-MRSA and anti-PSAR therapies by day 3, respectively. There was no difference in composite treatment failure (35.0% DE vs. 33.8% NDE, P=0.604). DE was not associated with treatment failure on Cox multivariate regression analysis (HR 1.13, 95% CI 0.97-1.33, P=0.149). Patients receiving DE had fewer antimicrobial days (median 9 vs. 11, P&lt; 0.0001), episodes of Clostridioides difficile (2.2% vs. 3.8%, P=0.046), and days of hospitalization (median 20 vs. 22 days, P=0.006). Figure 2: Median Spectrum Scores (SS) Days 0 to 28 Table 2: Cox Regression Analysis Conclusion DE and NDE resulted in similar rates of composite treatment failure at 30 days; however, DE was associated with fewer antimicrobial days, episodes of C. difficile, and days of hospitalization. Spectrum scores can objectively identify DE, but further studies are needed to fully understand their utility in this context. Disclosures Tamara Krekel, PharmD, BCPS, BCIDP, Merck (Speaker’s Bureau) David J. Ritchie, PharmD, BCPS (AQ-ID), AbbVie (Speaker’s Bureau)Merck (Speaker’s Bureau)" @default.
• W4200417847 created "2021-12-31" @default.
• W4200417847 creator A5005414576 @default.
• W4200417847 creator A5016146578 @default.
• W4200417847 creator A5025825030 @default.
• W4200417847 creator A5049174668 @default.
• W4200417847 creator A5062307271 @default.
• W4200417847 creator A5063212821 @default.
• W4200417847 date "2021-11-01" @default.
• W4200417847 modified "2023-09-30" @default.
• W4200417847 title "1319. Assessment of Spectrum Score-Based Antibiotic De-Escalation in Patients with Nosocomial Pneumonia" @default.
• W4200417847 doi "https://doi.org/10.1093/ofid/ofab466.1511" @default.
• W4200417847 hasPublicationYear "2021" @default.
• W4200417847 type Work @default.
• W4200417847 citedByCount "0" @default.
• W4200417847 crossrefType "journal-article" @default.
• W4200417847 hasAuthorship W4200417847A5005414576 @default.
• W4200417847 hasAuthorship W4200417847A5016146578 @default.
• W4200417847 hasAuthorship W4200417847A5025825030 @default.
• W4200417847 hasAuthorship W4200417847A5049174668 @default.
• W4200417847 hasAuthorship W4200417847A5062307271 @default.
• W4200417847 hasAuthorship W4200417847A5063212821 @default.
• W4200417847 hasBestOaLocation W42004178471 @default.
• W4200417847 hasConcept C126322002 @default.
• W4200417847 hasConcept C167135981 @default.
• W4200417847 hasConcept C2776102371 @default.
• W4200417847 hasConcept C2777914695 @default.
• W4200417847 hasConcept C2778314733 @default.
• W4200417847 hasConcept C71924100 @default.
• W4200417847 hasConcept C77350462 @default.
• W4200417847 hasConceptScore W4200417847C126322002 @default.
• W4200417847 hasConceptScore W4200417847C167135981 @default.
• W4200417847 hasConceptScore W4200417847C2776102371 @default.
• W4200417847 hasConceptScore W4200417847C2777914695 @default.
• W4200417847 hasConceptScore W4200417847C2778314733 @default.
• W4200417847 hasConceptScore W4200417847C71924100 @default.
• W4200417847 hasConceptScore W4200417847C77350462 @default.
• W4200417847 hasIssue "Supplement_1" @default.
• W4200417847 hasLocation W42004178471 @default.
• W4200417847 hasLocation W42004178472 @default.
• W4200417847 hasOpenAccess W4200417847 @default.
• W4200417847 hasPrimaryLocation W42004178471 @default.
• W4200417847 hasRelatedWork W1572305784 @default.
• W4200417847 hasRelatedWork W1645460010 @default.
• W4200417847 hasRelatedWork W1974936254 @default.
• W4200417847 hasRelatedWork W1975808987 @default.
• W4200417847 hasRelatedWork W2053630622 @default.
• W4200417847 hasRelatedWork W2342828429 @default.
• W4200417847 hasRelatedWork W3030305913 @default.
• W4200417847 hasRelatedWork W4283729922 @default.
• W4200417847 hasRelatedWork W4309683112 @default.
• W4200417847 hasRelatedWork W4312126724 @default.
• W4200417847 hasVolume "8" @default.
• W4200417847 isParatext "false" @default.
• W4200417847 isRetracted "false" @default.
• W4200417847 workType "article" @default.