Modelling the implementation of narrow versus broader spectrum antibiotics in the empiric treatment of E. coli bacteraemia
Rattachement africain : dk, gb. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
The implementation of new antimicrobial resistance stewardship programs is crucial in optimizing antibiotic use. However, prescription choices can be difficult during empiric therapy; clinicians must balance the survival benefits of broader spectrum antibiotics with associated increases in resistance. The aim of this study was to evaluate the overall feasibility of switching to narrow spectrum antibiotics during the empiric treatment of E. coli bacteraemia by quantifying changes in resistance rates, antibiotic usage, and mortality using a deterministic state-transition model. Three unique model scenarios (A, B, and C), each representing a progressively broader spectrum empiric treatment regimen, were used to compare outcomes at 5 years. We show that the empiric use of the narrowest spectrum (first-line) antibiotics can lead to reductions in resistance to second-line antibiotics and the use of third-line antibiotics, but they also lead to increases in resistance to first-line therapy and higher mortality. Crucially, we find that shortening the duration of empiric and overall treatment, as well as reducing the baseline mortality rate, are important for increasing the feasibility of switching to narrow spectrum antibiotics in the empiric treatment of E. coli bacteraemia. We provide a flexible model design to investigate optimal treatment approaches for other bacterial infections.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Modelling the implementation of narrow versus broader spectrum antibiotics in the empiric treatment of E. coli bacteraemia
- Date Crossref
- 23/07/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Copenhagen Department of Public Health pays non établi dans la noticeUniversité ou école supérieure
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Imperial College London pays non établi dans la noticeUniversité ou école supérieure
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London School of Hygiene & Tropical Medicine pays non établi dans la noticeUniversité ou école supérieure
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School of Public Health MRC Centre for Global Infectious Disease Analysis pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Epidemiology and Population Health Department of Infectious Disease Epidemiology pays non établi dans la noticeUniversité ou école supérieure
Department of Public Health — University of Copenhagen, Imperial College London et London School of Hygiene & Tropical Medicine, avec 2 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.