Determinants of antimicrobial use and de-escalation in critical care
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De-escalation is applied in no more than 15-50% of patients in most studies, and may consist of different components. There may be important differences between hospitals and countries in the use of de-escalation as well as the impact on outcome thereof. Large scale, multi-country studies are currently lacking.
This study from the Infection Section aims to include 2000 patients in whom empirical antibiotics are started. With an estimated de-escalation rate of 35%, we estimate to include 700 patients in whom de-escalation is performed which would allow for a suitable multivariable analysis.
The trial, starting in the 2nd semester of 2016, will give us further insights into the actual use of de-escalation in a global sample of patients, inform us about the determinants of de-escalation, as well as describe the impact of de-escalation, taking various potential confounders into account.