THE DE-ESCALATION CONCEPT and ANTIBIOTIC DE-ESCALATION: A MISSED OPPORTUNITY?

THE DE-ESCALATION CONCEPT and ANTIBIOTIC DE-ESCALATION: A MISSED OPPORTUNITY?

Autor Camargo, Luis Fernando Aranha Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Hosp Israelita Albert Einstein
Resumo 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.
Palavra-chave Antibiotic
de-escalation therapy
Idioma Inglês
Data de publicação 2013-05-01
Publicado em Shock. Philadelphia: Lippincott Williams & Wilkins, v. 39, n. 7, p. 29-31, 2013.
ISSN 1073-2322 (Sherpa/Romeo, fator de impacto)
Publicador Lippincott Williams & Wilkins
Extensão 29-31
Fonte http://dx.doi.org/10.1097/SHK.0b013e31828faf02
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000330251000007
Endereço permanente http://repositorio.unifesp.br/handle/11600/36237

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