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Carbapenem De-escalation Therapy in a Resource-Limited Setting

Published online by Cambridge University Press:  02 January 2015

Anucha Apisarnthanarak ,
Nuntanij Bhooanusas ,
Apiwat Yaprasert  and
Linda M. Mundy
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Thammasat University Hospital, Pratumthani, Thailand
Nuntanij Bhooanusas
Affiliation:
Division of Infectious Diseases, Thammasat University Hospital, Pratumthani, Thailand
Apiwat Yaprasert
Affiliation:
Padreaw Medical Equipment Shop, Chachoengsao, Thailand
Linda M. Mundy
Affiliation:
Bryn Mawr, Pennsylvania
*
Division of Infectious Diseases, Thammasat University Hospital, Pratumthani, Thailand, 12120 ([email protected])
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Abstract

Pulmonary infection (P = .01) and an infectious diseases consultation (P = .04) were associated with carbapenem de-escalation; pulmonary infection and septic shock were associated with unsuccessful de-escalation. Successful de-escalaltion was associated with lower mortality (0% vs 23%; P < .001) and shorter duration of carbapenem use (4 vs 10 days; P ≤.001).

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 12 , December 2013 , pp. 1310 - 1313
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Apisarnthanarak, A, Hsu, LY, Khawcharoenporn, T, Mundy, LM. Carbapenem-resistant gram-negative bacteria: how to prioritize infection prevention and control interventions in resource-limited settings? Expert Rev Anti Infect Ther 2013;11:147–157.Google Scholar
2.Rello, J. Importance of appropriate initial antibiotic therapy and de-escalation in the treatment of nosocomial pneumonia. Eur Respir Rev 2007;16:33–39.CrossRefGoogle Scholar
3.Kollef, MH. Optimizing antibiotic therapy in the intensive care unit setting. Crit Care 2001;5:189–195.CrossRefGoogle Scholar
4.Apisarnthanarak, A, Mundy, LM. Role of combination antibiogram in empirical treatment of infection due to multidrug-resistant Acinetobacter baumannii. Infect Control Hosp Epidemiol 2008;29:678–679.Google Scholar
5.Apisarnthanarak, A, Kiratisin, RMundy, LM. Clinical and molecular epidemiology of healthcare-associated infections due to extended-spectrum beta-lactamase (ESBL)-producing strains of Escherichia coli and Klebsiella pneumoniae that harbor multiple ESBL genes. Infect Control Hosp Epidemiol 2008;29:1026–1034.Google Scholar
6.Falagas, ME, Karageorgopoulos, DE. Pandrug resistance (PDR), extensive drug resistance (XDR), and multidrug resistance (MDR) among gram-negative bacilli: need for international harmonization in terminology. Clin Infect Dis 2008;46:1121–1122.CrossRefGoogle ScholarPubMed
7.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
8.Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309–332.CrossRefGoogle ScholarPubMed
9.Masterton, RG. Antibiotic de-escalation. Crit Care Clin 2011;27:149–162.Google Scholar
10.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;33:1533–1540.Google Scholar
11.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. De-escalation after empirical meropenem treatment in the intensive care unit: fiction or reality? J Crit Care 2010;25:641–646.Google Scholar
12.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;44:159–177.Google Scholar