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Current Infectious Disease Reports

Erschienen in:

01.04.2017 | Healthcare Associated Infections (G Bearman and D Morgan, Section Editors)

De-escalating Antibiotic Use in the Inpatient Setting: Strategies, Controversies, and Challenges

verfasst von: J. Daniel Markley, Shaina Bernard, Gonzalo Bearman, Michael P. Stevens

Erschienen in: Current Infectious Disease Reports | Ausgabe 4/2017

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Abstract

Purpose of Review

Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting.

Recent Findings

A consensus definition of ADE remains elusive at this time. Preliminary studies utilizing rapid diagnostic tests including matrix-assisted laser desorption/ionization time of flight (MALDI-TOF), procalcitonin, and other molecular techniques have demonstrated the potential to support ADE strategies.

Summary

In the absence of evidence-based, highly specific ADE protocols, the likelihood that individual providers will make consistent, often challenging, decisions to de-escalate antibiotic therapy is low. Antimicrobial stewardship programs should support local physicians with ADE and develop innovative ways to integrate ADE into the broader construct of antimicrobial stewardship programs. The evolving field of rapid diagnostics has significant potential to improve ADE strategies, but more research is needed to fully realize this goal.

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Titel: De-escalating Antibiotic Use in the Inpatient Setting: Strategies, Controversies, and Challenges
verfasst von: J. Daniel Markley
Shaina Bernard
Gonzalo Bearman
Michael P. Stevens
Publikationsdatum: 01.04.2017
Verlag: Springer US
Erschienen in: Current Infectious Disease Reports / Ausgabe 4/2017
Print ISSN: 1523-3847
Elektronische ISSN: 1534-3146
DOI: https://doi.org/10.1007/s11908-017-0575-8

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