Affordable Access

deepdyve-link
Publisher Website

The "de-escalation concept" and antibiotic de-escalation: a missed opportunity?

Authors
  • Camargo, Luis Fernando A
Type
Published Article
Journal
Shock (Augusta, Ga.)
Publication Date
May 01, 2013
Volume
39 Suppl 1
Pages
29–31
Identifiers
DOI: 10.1097/SHK.0b013e31828faf02
PMID: 23481499
Source
Medline
License
Unknown

Abstract

"De-escalation therapy" is a term that suggests the need to reduce the spectrum or the number of antibiotics formerly prescribed for critical patients, upon clinical improvement and/or microorganism recovery. The major goal of this concept is the use of broad-spectrum antibiotic agents as initial drugs of choice for severe patients, instead of "reserving" the most potent agents after an inadequate clinical response, or after the microorganism is recovered. Despite possible commercial concerns and an unproven but possible relationship with enhancing global antibiotic use, the concept was correct and in accordance with scientific evidence. However, the "de-escalation" component of the concept is very seldom reported, and no large clinical trial on this issue is available until today. To definitely put in practice this concept, comparative large trials must be designed and sponsored to insert this strategy at the same level of evidence of wide initial empiric antibiotic treatments.

Report this publication

Statistics

Seen <100 times