%0 Journal Article
%A Sadyrbaeva-Dolgova, Svetlana
%A Aznarte-Padial, Pilar
%A Pasquau-Liaño, Juan
%A Expósito-Ruiz, Manuela
%A Calleja Hernández, Miguel Ángel
%A Hidalgo-Tenorio, Carmen
%T Clinical outcomes of carbapenem de-escalation regardless of microbiological results: A propensity score analysis.
%D 2019
%U http://hdl.handle.net/10668/13939
%X The aim of this study was to evaluate the safety and efficacy of de-escalation in patients under treatment with carbapenems and its impact on clinical outcomes. A prospective observational study was conducted for 1year. Patients administered active carbapenems for at least 24h were included. Primary outcomes were in-hospital mortality, mortality at 30 days after carbapenem prescription, and infection-related readmission within 30 days. De-escalation was defined as the substitution of carbapenem with narrower spectrum antimicrobial agents or its discontinuation during the first 96h of treatment. The study included 1161 patients, and de-escalation was performed in 667 (57.5%) of these. In the de-escalation group, 54.9% of cultures were positive. After propensity score matching, 30-day mortality was lower (17.4% vs. 25.7%, p=0.036), carbapenem treatment was 4 days shorter (4 vs. 8 days, p Carbapenem de-escalation is a safe strategy that does not compromise the clinical status of patients.
%K Antimicrobial stewardship programme
%K Carbapenems
%K De-escalation
%K Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae
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