Journal article
A systematic review of the methods used to assess the association between appropriate antibiotic therapy and mortality in bacteremic patients
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol.45(3), pp.329-337
08/01/2007
DOI: 10.1086/519283
PMID: 17599310
Abstract
Studies of the association between inappropriate antibiotic therapy and mortality among bacteremic patients have generated conflicting findings. We systematically reviewed these studies to identify methodological heterogeneity that may explain the lack of agreement. We identified 51 articles that met the inclusion criteria, and we extracted the following data: study design, definition and measurement of variables, and statistical methods. Only 8 studies (16%) defined inappropriate antibiotic therapy as that which was inactive in vitro against the isolated organism(s) and not consistent with current clinical practice recommendations and distinguished between empiric and definitive treatment. Thirty-four studies (67%) measured the severity of illness, but only 6 (12%) specified the time at which it was measured. The methodological recommendations suggested in this article are intended to improve the validity and generalizability of future research. In brief, future studies should define "inappropriate" therapy on the basis of in vitro susceptibility data, should separately evaluate empiric and definitive therapy, and should control for the baseline severity of illness.
Details
- Title: Subtitle
- A systematic review of the methods used to assess the association between appropriate antibiotic therapy and mortality in bacteremic patients
- Creators
- Jessina C McGregor - Oregon State University College of Pharmacy, Portland, OR 97239, USA. mcgregoj@ohsu.eduShayna E RichAnthony D HarrisEli N PerencevichRegina OsihThomas P Lodise JrRam R MillerJon P Furuno
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol.45(3), pp.329-337
- Publisher
- United States
- DOI
- 10.1086/519283
- PMID
- 17599310
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Grant note
- 1K23AI001752-01A1 / NIAID NIH HHS 1R01A160859-01A1 / PHS HHS P60 AG12583 / NIA NIH HHS 1K12RR023250-01 / NCRR NIH HHS
- Language
- English
- Date published
- 08/01/2007
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983779491702771
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