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Open Access 01-07-2020 | Antibiotic | Review

Antimicrobial De-Escalation in the ICU: From Recommendations to Level of Evidence

Authors: Ines Lakbar, Jan J. De Waele, Alexis Tabah, Sharon Einav, Ignacio Martin-Loeches, Marc Leone

Published in: Advances in Therapy | Issue 7/2020

Abstract

Antimicrobial de-escalation (ADE) is a component of antimicrobial stewardship (AMS) aimed to reduce exposure to broad-spectrum antimicrobials. In the intensive care unit, ADE is a strong recommendation that is moderately applied in clinical practice. Following a systematic review of the literature, we assessed the studies identified on the topic which included one randomized controlled trial and 20 observational studies. The literature shows a low level of evidence, although observational studies suggested that this procedure is safe. The effects of ADE on the level of resistance of ecological systems and especially on the microbiota are unclear. The reviewers recommend de-escalating antimicrobial treatment in patients requiring long-term antibiotic therapy and considering de-escalation in short-term treatments.

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Title: Antimicrobial De-Escalation in the ICU: From Recommendations to Level of Evidence
Authors: Ines Lakbar
Jan J. De Waele
Alexis Tabah
Sharon Einav
Ignacio Martin-Loeches
Marc Leone
Publication date: 01-07-2020
Publisher: Springer Healthcare
Keywords: Antibiotic
Respiratory Microbiota
Published in: Advances in Therapy / Issue 7/2020
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI: https://doi.org/10.1007/s12325-020-01390-2

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